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
1	291U00000X	Clinical Medical Laboratory
2	332B00000X	Durable Medical Equipment & Medical Supplies
3	3336C0003X	Community/Retail Pharmacy
4	333600000X	Pharmacy	10653	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	4547165	OTHER	OTHER ID NUMBER-COMMERCIAL NUMBER

General Provider Information

NPI Number	:	1063427169
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	:	61834-4509
Country	:	US
Telephone Number	:	847-527-2489
Fax Number	:	217-709-2344

Provider Business Practice Location Address
First Line	:	8045 N LOOP DR
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79915-3227
Country	:	US
Telephone Number	:	915-592-5849
Fax Number	:	915-592-5412

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

Provider Enumeration Date	:	07/29/2006
Last Update Date	:	03/27/2025

Similar Medicare Providers

1164426748 — DR. MARIA GUADALUPE CARDENAS M.D.
Practice Location Address:

8045 N LOOP DR STE A
EL PASO, TX
79915-3227

Practice Phone: 915-248-1793
Practice Fax: 915-225-3745

1609017623 — BILHA ANNA CANDELARIA N.P.
Practice Location Address:

8045 N LOOP DR STE A
EL PASO, TX
79915-3227

Practice Phone: 915-248-1793
Practice Fax: 915-225-3745

1578892279 — GABRIEL ALCOCER PHARM.D.
Practice Location Address:

8045 N LOOP DR
EL PASO, TX
79915-3227

Practice Phone: 915-592-5848
Practice Fax: 915-592-5412

1124349667 — DR. DIEGO DE LA MORA M.D.
Practice Location Address:

8045 N LOOP DR STE A
EL PASO, TX
79915-3227

Practice Phone: 915-215-5167
Practice Fax: 915-215-8640

1801106786 — SARA CATHERINE SMITH PHARMD
Practice Location Address:

8045 N LOOP DR
EL PASO, TX
79915-3227

Practice Phone: 915-592-5849
Practice Fax:

1174806160 — DR. DELORA PINEDA B.S., PHARM D, RPH
Practice Location Address:

8045 N LOOP DR
EL PASO, TX
79915-3227

Practice Phone: 915-592-5849
Practice Fax: 915-592-5412

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.