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	5301007625	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2364406	OTHER	OTHER ID NUMBER-COMMERCIAL NUMBER
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1578578613
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	:	1309 S MISSION ST
Second Line	:
City	:	MT PLEASANT
State	:	MI
Zip	:	48858-4207
Country	:	US
Telephone Number	:	989-775-8098
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	JENNIFER PONCE
Credential	:
Telephone Number	:	157-857-8613

Provider Enumeration Date	:	07/29/2006
Last Update Date	:	01/12/2026

Similar Medicare Providers

1780680306 — MARLENE MICHALOWSKI O.G.N.P.
Practice Location Address:

1325 S MISSION ST
MT PLEASANT, MI
48858-4207

Practice Phone: 989-773-5602
Practice Fax: 989-775-3305

1255302964 — MS. MARY B SCHAEFER RPH
Practice Location Address:

1309 S MISSION ST
MT PLEASANT, MI
48858-4207

Practice Phone: 989-775-8051
Practice Fax: 989-779-0921

1285745893 — PLANNED PARENTHOOD OF WEST & NORTHERN MICHIGAN, INC
Practice Location Address:

1325 S MISSION ST
MT PLEASANT, MI
48858-4207

Practice Phone: 989-773-5602
Practice Fax: 989-775-3305

1134504756 — BENJAMIN JACKSON RPH
Practice Location Address:

1309 S MISSION ST
MT PLEASANT, MI
48858-4207

Practice Phone: 989-775-8098
Practice Fax:

1841573045 — DR. AMY ALEXANDRA MERRILL PHARM D
Practice Location Address:

1309 S MISSION ST
MOUNT PLEASANT, MI
48858-4207

Practice Phone: 989-775-8098
Practice Fax:

1659963346 — MCLAREN HEALTH MANAGEMENT GROUP
Practice Location Address:

1309 S MISSION ST
MOUNT PLEASANT, MI
48858-4207

Practice Phone: 989-317-3883
Practice Fax: 810-600-7899

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.