DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
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
13336C0003XCommunity/Retail Pharmacy
2332B00000XDurable Medical Equipment & Medical Supplies
3333600000XPharmacy57391381703UT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
14609597OTHEROTHER ID NUMBER-COMMERCIAL NUMBER
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1639184666
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 : 1962 W 1800 N
Second Line :
City : CLINTON
State : UT
Zip : 84015-8328
Country : US
Telephone Number : 801-614-1347
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 : 02/06/2026

Similar Medicare Providers

1700167186 — BRONSTON M GREENWOOD II RPH
Practice Location Address:
1962 W 1800 N
CLINTON, UT
84015-8328
Practice Phone: 801-614-1347
Practice Fax:
1487936837 — MR. WELFORD G SANFORD JR. RPH
Practice Location Address:
1962 W 1800 N
CLINTON, UT
84015-8328
Practice Phone: 801-614-1347
Practice Fax:
1295076339 — TODD C BARNEY PHARMD
Practice Location Address:
1962 W 1800 N
CLINTON, UT
84015-8328
Practice Phone: 801-614-1347
Practice Fax:
1174134688 — JAIME LYNN PETERSON PHARMD
Practice Location Address:
1962 W 1800 N
CLINTON, UT
84015-8328
Practice Phone: 801-502-5310
Practice Fax:
1831702679 — DR. KATHLEEN JOANNA NEWTON PHARMD
Practice Location Address:
1962 W 1800 N
CLINTON, UT
84015-8328
Practice Phone: 801-614-1347
Practice Fax:
1801466750 — COLTON KURT WASHBURN RPH
Practice Location Address:
1962 W 1800 N
CLINTON, UT
84015-8328
Practice Phone: 801-614-1347
Practice Fax:

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.