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	PHY45688	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	0565260	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	:	1518972801
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	:	12490 CENTRAL AVE
Second Line	:
City	:	CHINO
State	:	CA
Zip	:	91710-2603
Country	:	US
Telephone Number	:	909-464-9520
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	:	06/09/2026

Similar Medicare Providers

1003982075 — DR. MARIA JESUSA TECSON CHOY DDS
Practice Location Address:

12400 CENTRAL AVE
CHINO, CA
91710-2603

Practice Phone: 909-364-0030
Practice Fax: 909-591-8779

1467529420 — DR. JANICE TAN CHENG D.M.D.
Practice Location Address:

12400 CENTRAL AVE
CHINO, CA
91710-2603

Practice Phone: 909-364-0030
Practice Fax: 909-591-8779

1275686354 — WESTERN DENTAL SERVICES, INC.
Practice Location Address:

12400 CENTRAL AVE
CHINO, CA
91710-2603

Practice Phone: 909-364-0030
Practice Fax: 909-591-8779

1548486707 — DR. FARHEEN SHARIFF
Practice Location Address:

12400 CENTRAL AVE
CHINO, CA
91710-2603

Practice Phone: 909-364-0030
Practice Fax: 909-591-8779

1760768162 — DR. IRENE GUANO ALVAREZ PHARMD
Practice Location Address:

12490 CENTRAL AVE
CHINO, CA
91710-2603

Practice Phone: 909-464-9520
Practice Fax:

1790062958 — DR. NEAL ABRAHAM PHARMD
Practice Location Address:

12490 CENTRAL AVE
CHINO, CA
91710-2603

Practice Phone: 909-464-9520
Practice Fax: 909-464-9910

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.