DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: WALGREEN CO

MEDICARE: WALGREEN CO
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
13336C0003XCommunity/Retail Pharmacy
2332B00000XDurable Medical Equipment & Medical Supplies
3333600000XPharmacyPH0007787FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11042427OTHEROTHER ID NUMBER-COMMERCIAL NUMBER
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1689689887
Entity Type Code : Organization
Provider Name (Legal Business Name) : WALGREEN CO
Provider Business Mailing Address
First Line : 1901 E VOORHEES ST
Second Line : MS 790
City : DANVILLE
State : IL
Zip : 61834-4515
Country : US
Telephone Number : 847-527-2489
Fax Number : 217-709-2344
Provider Business Practice Location Address
First Line : 4029 S SUNCOAST BLVD
Second Line :
City : HOMOSASSA
State : FL
Zip : 34446-1175
Country : US
Telephone Number : 352-628-3898
Fax Number :
Authorized Official
Title or Position : MANAGER
Name : JENNIFER PONCE
Credential :
Telephone Number : 847-527-2489
Provider Enumeration Date : 07/29/2006
Last Update Date : 02/10/2026

Similar Medicare Providers

1194005785 — MR. SHAWN RICE R.PH.
Practice Location Address:
4029 S SUNCOAST BLVD
HOMOSASSA, FL
34446-1175
Practice Phone: 352-628-3898
Practice Fax: 352-628-9399
1437439957 — LADONNA ROSE EDGE PARM D
Practice Location Address:
4029 S SUNCOAST BLVD
HOMOSASSA, FL
34446-1175
Practice Phone: 352-628-3898
Practice Fax:
1407126691 — MS. JULIE LYNN DEWOODY PHARMD.
Practice Location Address:
4029 S SUNCOAST BLVD
HOMOSASSA, FL
34446-1175
Practice Phone: 325-628-3898
Practice Fax: 352-628-9399
1629348321 — DAVID GOUDIE
Practice Location Address:
4029 S SUNCOAST BLVD
HOMOSASSA, FL
34446-1175
Practice Phone: 352-628-3898
Practice Fax:
1245608850 — DR. NICOLE M CHILSON PHARMD
Practice Location Address:
4029 S SUNCOAST BLVD
HOMOSASSA, FL
34446-1175
Practice Phone: 352-628-3898
Practice Fax: 352-628-9399
1790360667 — ANDREW MESIHA
Practice Location Address:
4029 S SUNCOAST BLVD
HOMOSASSA, FL
34446-1175
Practice Phone: 352-628-3898
Practice Fax:

Directions to “WALGREEN CO ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.