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	3336C0003X	Community/Retail Pharmacy
2	332B00000X	Durable Medical Equipment & Medical Supplies
3	333600000X	Pharmacy	60004861A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	1532426	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	:	1780699827
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	:	1300 WABASH AVE
Second Line	:
City	:	TERRE HAUTE
State	:	IN
Zip	:	47807-3314
Country	:	US
Telephone Number	:	812-234-5147
Fax Number	:	812-232-1274

Authorized Official
Title or Position	:	MANAGER
Name	:	JENNIFER PONCE
Credential	:
Telephone Number	:	847-527-2489

Provider Enumeration Date	:	07/29/2006
Last Update Date	:	10/22/2025

Similar Medicare Providers

1346221660 — JUDITH HERTANU MD
Practice Location Address:

10 UNION SQ E , BETH ISRAEL MED CTR- DEPT OF REHAB MEDICARE
NEW YORK, NY
10003-3314

Practice Phone: 212-420-2757
Practice Fax:

1699057463 — MR. STEVEN ERIC MYERS RPH
Practice Location Address:

1300 WABASH AVE
TERRE HAUTE, IN
47807-3314

Practice Phone: 812-243-5623
Practice Fax: 812-232-1274

1770869331 — DR. ASHLEY SWEARINGEN PHARM.D.
Practice Location Address:

1300 WABASH AVE
TERRE HAUTE, IN
47807-3314

Practice Phone: 812-234-5147
Practice Fax:

1154664217 — RYAN BONOMO RPH
Practice Location Address:

1300 WABASH AVE
TERRE HAUTE, IN
47807-3314

Practice Phone: 812-234-5147
Practice Fax: 812-232-1274

1033534854 — DR. TOCHI OHALE PHARMD
Practice Location Address:

1300 WABASH AVE
TERRE HAUTE, IN
47807-3314

Practice Phone: 812-234-5147
Practice Fax: 812-232-1274

1689537425 — JOHN WILLIAM MCCARTER
Practice Location Address:

1341 OHIO ST
TERRE HAUTE, IN
47807-3940

Practice Phone: 812-266-0974
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 © 2007-2025 (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.