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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
1332B00000XDurable Medical Equipment & Medical Supplies
23336C0003XCommunity/Retail Pharmacy
3333600000XPharmacy261645MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
22423010OTHEROTHER ID NUMBER-COMMERCIAL NUMBER

General Provider Information

NPI Number : 1396750519
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 : 11401 MARKETPLACE DR N
Second Line :
City : CHAMPLIN
State : MN
Zip : 55316-3794
Country : US
Telephone Number : 763-427-6389
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 : 05/21/2026

Similar Medicare Providers

1871878850 — MRS. JULIE A ANDERSON RPH
Practice Location Address:
11401 MARKETPLACE DR N
CHAMPLIN, MN
55316-3794
Practice Phone: 763-427-6389
Practice Fax:
1639455041 — JOEL SKOOG PHARMD
Practice Location Address:
11401 MARKETPLACE DR N
CHAMPLIN, MN
55316-3794
Practice Phone: 763-427-6389
Practice Fax:
1346527413 — KIM M REIFF RPH
Practice Location Address:
11401 MARKETPLACE DR N
CHAMPLIN, MN
55316-3794
Practice Phone: 763-427-6389
Practice Fax: 763-427-2520
1922375286 — MR. MICHAEL HAGELIN RPH
Practice Location Address:
11401 MARKETPLACE DR N
CHAMPLIN, MN
55316-3794
Practice Phone: 763-427-6389
Practice Fax: 763-425-2520
1255742144 — DR. DANIEL ROEHL PHARM D.
Practice Location Address:
11401 MARKETPLACE DR N
CHAMPLIN, MN
55316-3794
Practice Phone: 763-427-6389
Practice Fax:
1558975821 — SPENCER TODD STROMBACK PHARM D.
Practice Location Address:
11401 MARKETPLACE DR N
CHAMPLIN, MN
55316-3794
Practice Phone: 763-427-6389
Practice Fax: 763-427-2520

Directions to “WALGREEN CO ” Practice Location

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