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	332B00000X	Durable Medical Equipment & Medical Supplies
2	3336C0003X	Community/Retail Pharmacy
3	333600000X	Pharmacy	28RS00727100	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	3198834	OTHER		NCPDP

General Provider Information

NPI Number	:	1134481039
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	:	2703 RTE 130
Second Line	:
City	:	NORTH BRUNSWICK
State	:	NJ
Zip	:	08902-4721
Country	:	US
Telephone Number	:	732-821-1293
Fax Number	:	732-821-1797

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

Provider Enumeration Date	:	06/15/2012
Last Update Date	:	08/06/2025

Similar Medicare Providers

1154287910 — DR. LEIANNI ANJOLI XUE-LING WONG PHARMD
Practice Location Address:

2703 US HIGHWAY 130
NORTH BRUNSWICK, NJ
08902-4721

Practice Phone: 732-821-1293
Practice Fax: 732-821-1797

1114394988 — MISS SHIRLANE A BOWEN APN
Practice Location Address:

2703 US HIGHWAY 130 STE 100
NORTH BRUNSWICK, NJ
08902-4721

Practice Phone: 732-934-4892
Practice Fax: 732-838-1905

1295718476 — LABORATORY CORPORATION OF AMERICA HOLDINGS
Practice Location Address:

2436 PARKWOOD DR
BRUNSWICK, GA
31520-4721

Practice Phone: 912-267-6110
Practice Fax:

1093829384 — DR. HENRY WARNOCK FLOURNOY M.D.
Practice Location Address:

2444 PARKWOOD DR
BRUNSWICK, GA
31520-4721

Practice Phone: 912-267-0424
Practice Fax: 912-264-0954

1932218617 — COSTAL GEORGIA VEIN CENTER INC.
Practice Location Address:

2444 PARKWOOD DR
BRUNSWICK, GA
31520-4721

Practice Phone: 912-267-9550
Practice Fax: 912-264-5128

1487748455 — HEALTHSCANL
Practice Location Address:

2414 PARKWOOD DR # B
BRUNSWICK, GA
31520-4721

Practice Phone: 912-280-9211
Practice Fax: 912-280-9068

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.