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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
3333600000XPharmacy2000153869MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
22633130OTHEROTHER ID NUMBER-COMMERCIAL NUMBER
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1548275571
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 : 600 W KARSCH BLVD
Second Line :
City : FARMINGTON
State : MO
Zip : 63640-3342
Country : US
Telephone Number : 573-747-1591
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 : 03/30/2026

Similar Medicare Providers

1326061805 — PHILLIP G WILLMORE RPH
Practice Location Address:
600 W KARSCH BLVD
FARMINGTON, MO
63640-3342
Practice Phone: 573-747-1591
Practice Fax:
1497039879 — MR. JOSEPH BERNARD POTTER RPH
Practice Location Address:
600 W KARSCH BLVD
FARMINGTON, MO
63640-3342
Practice Phone: 573-747-1591
Practice Fax: 573-747-0761
1134404825 — KRISTIN KEUTZER
Practice Location Address:
600 W KARSCH BLVD
FARMINGTON, MO
63640-3342
Practice Phone: 573-747-1591
Practice Fax:
1134404791 — MR. GREGORY JOSEPH RUDROFF RPH
Practice Location Address:
600 W KARSCH BLVD
FARMINGTON, MO
63640-3342
Practice Phone: 573-756-7861
Practice Fax:
1609151695 — MR. PAUL RAY MOYERS RPH
Practice Location Address:
600 W KARSCH BLVD
FARMINGTON, MO
63640-3342
Practice Phone: 573-747-1591
Practice Fax:
1407132525 — KRISTIE HALTER
Practice Location Address:
600 W KARSCH BLVD
FARMINGTON, MO
63640-3342
Practice Phone: 573-747-1591
Practice Fax: 573-747-0761

Directions to “WALGREEN CO ” Practice Location

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