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	2-4389	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	3700069	OTHER	OTHER ID NUMBER-COMMERCIAL NUMBER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326053380
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WALGREEN CO

Provider Business Mailing Address
First Line	:	1901 E VOORHEES ST # MS 790
Second Line	:
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	:	1438 N LEWIS AVE
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74110-4705
Country	:	US
Telephone Number	:	918-583-7593
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	:	08/04/2025

Similar Medicare Providers

1689959389 — DR. OLIVIA RAYE OCHOA PHARMD
Practice Location Address:

1438 N LEWIS AVE
TULSA, OK
74110-4705

Practice Phone: 918-583-7593
Practice Fax: 918-583-0672

1851669089 — MR. EVERETT FRANKLIN LACY R.PH.
Practice Location Address:

1438 N LEWIS AVE.
TULSA, OK
74110-4705

Practice Phone: 918-583-7593
Practice Fax: 918-583-0672

1023018819 — MELISSA B MYERS DO
Practice Location Address:

4705 S 129TH EAST AVE
TULSA, OK
74134-7005

Practice Phone: 918-615-7261
Practice Fax: 404-494-7549

1417051921 — DR. N DEVONNA A'BELLE PA-C, DMSC
Practice Location Address:

4705 S 129TH EAST AVE
TULSA, OK
74134-7005

Practice Phone: 918-727-2790
Practice Fax:

1205268380 — MEDSTAFF
Practice Location Address:

4705 S 129TH EAST AVE
TULSA, OK
74134-7005

Practice Phone: 918-615-7020
Practice Fax: 918-615-7022

1225618804 — KELLEY REBEKAH STUCKEY MSN, APRN-CNP, FNP-C
Practice Location Address:

4705 S 129TH EAST AVE
TULSA, OK
74134-7005

Practice Phone: 833-863-3947
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.