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	3336C0003X	Community/Retail Pharmacy
2	332B00000X	Durable Medical Equipment & Medical Supplies
3	333600000X	Pharmacy	PHRE009511	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	1157545	OTHER	NCPDP
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	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1346403045
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	:	4210 AUGUSTA RD
Second Line	:
City	:	GARDEN CITY
State	:	GA
Zip	:	31408-2106
Country	:	US
Telephone Number	:	912-964-4311
Fax Number	:	912-964-4358

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

Provider Enumeration Date	:	07/03/2008
Last Update Date	:	02/11/2026

Similar Medicare Providers

1679870885 — DR. LORI LENNON PHARMD
Practice Location Address:

4210 AUGUSTA RD
GARDEN CITY, GA
31408-2106

Practice Phone: 912-964-4311
Practice Fax:

1013290220 — BRENDA SUZANNE SHARP RPH
Practice Location Address:

4210 AUGUSTA RD
GARDEN CITY, GA
31408-2106

Practice Phone: 912-964-4311
Practice Fax: 912-964-4358

1417324963 — MR. CHARLES REX THOMPSON II PHARMD
Practice Location Address:

4210 AUGUSTA RD
GARDEN CITY, GA
31408-2106

Practice Phone: 912-964-4311
Practice Fax: 912-964-4358

1033587217 — DR. MEGAN NICOLE BUNKLEY PHARMD
Practice Location Address:

4210 AUGUSTA RD
GARDEN CITY, GA
31408-2106

Practice Phone: 912-964-4311
Practice Fax:

1164403028 — DR. STEVEN KLEIN MD
Practice Location Address:

1401 ROBERT B MILLER JR RD
GARDEN CITY, GA
31408-9001

Practice Phone: 912-966-8222
Practice Fax: 912-966-8593

1750342192 — DAVID B BRADLEY OPTOMETRIST PC
Practice Location Address:

22 HARRELL DR
GARDEN CITY, GA
31408-2005

Practice Phone: 912-964-0483
Practice Fax: 912-964-0488

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.