MEDICARE: WALGREEN CO.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	3336C0003X	Community/Retail Pharmacy
2	332B00000X	Durable Medical Equipment & Medical Supplies
3	333600000X	Pharmacy

General Provider Information

NPI Number	:	1619846631
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WALGREEN CO.

Provider Business Mailing Address
First Line	:	1901 E VOORHEES STREET
Second Line	:	MS 790
City	:	DANVILLE
State	:	IL
Zip	:	61834-4509
Country	:	US
Telephone Number	:	847-527-2489
Fax Number	:	217-709-2344

Provider Business Practice Location Address
First Line	:	12475 NORTHLAKE BLVD
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33412-2761
Country	:	US
Telephone Number	:	561-491-7183
Fax Number	:	561-491-7184

Authorized Official
Title or Position	:	MANAGER
Name	:	JENNIFER PONCE
Credential	:
Telephone Number	:	847-527-2489

Provider Enumeration Date	:	10/30/2025
Last Update Date	:	11/01/2025

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Directions to “WALGREEN CO. ” Practice Location

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