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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
2291U00000XClinical Medical Laboratory
3332B00000XDurable Medical Equipment & Medical Supplies
4333600000XPharmacy22867TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
34532049OTHEROTHER ID NUMBER-COMMERCIAL NUMBER

General Provider Information

NPI Number : 1750396818
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 : 9625 WHITE SETTLEMENT RD
Second Line :
City : FORT WORTH
State : TX
Zip : 76108-4406
Country : US
Telephone Number : 817-367-3469
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 : 09/08/2025

Similar Medicare Providers

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Practice Location Address:
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FORT WORTH, TX
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Practice Phone: 817-367-9469
Practice Fax:
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Practice Fax:
1205164100 — MR. AHMED SAMY FATI
Practice Location Address:
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Practice Fax: 817-367-3560
1932496205 — DR. JON VELOSO JR. PHARM.D.
Practice Location Address:
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FORT WORTH, TX
76108-4406
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Practice Fax:
1891177820 — AVERY TOMBERLIN
Practice Location Address:
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FORT WORTH, TX
76108-4406
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Practice Fax:
1467835512 — HA LE PHARM.D.
Practice Location Address:
9625 WHITE SETTLEMENT RD
FORT WORTH, TX
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Directions to “WALGREEN CO ” Practice Location

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