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	19179	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	4502820	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	:	1851306815
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	:	2425 THOUSAND OAKS DR
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78232-3206
Country	:	US
Telephone Number	:	210-402-2927
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	:	11/21/2025

Similar Medicare Providers

1275862153 — DR. KOFI OSEI-BONSU PHARMD
Practice Location Address:

2425 THOUSAND OAKS DR
SAN ANTONIO, TX
78232-3206

Practice Phone: 210-402-2927
Practice Fax: 210-402-2991

1578232096 — PRIYANKA BHAGWANANI
Practice Location Address:

2425 THOUSAND OAKS DR
SAN ANTONIO, TX
78232-3206

Practice Phone: 210-402-2927
Practice Fax:

1215802988 — CATARINA GARZA
Practice Location Address:

2425 THOUSAND OAKS DR
SAN ANTONIO, TX
78232-3206

Practice Phone: 210-402-2927
Practice Fax:

1043494305 — MS. SCARLETT RAMEY MS, RDN, LD
Practice Location Address:

135 OLD SAN ANTONIO RD APT 3206
BOERNE, TX
78006-3433

Practice Phone: 206-910-8690
Practice Fax:

1891292256 — JOSHUA CROSS LAT
Practice Location Address:

1400 JACKSON KELLER RD
SAN ANTONIO, TX
78213-3206

Practice Phone: 210-356-0890
Practice Fax:

1497235543 — NE'ONEASHIA N. FORD RN
Practice Location Address:

3206 CRIPPLE CREEK ST APT 12E
SAN ANTONIO, TX
78209-2474

Practice Phone: 210-388-5212
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.