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	2136	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0317140	OTHER		OTHER ID NUMBER-COMMERCIAL NUMBER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1932114279
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	:	61834-4509
Country	:	US
Telephone Number	:	847-527-2489
Fax Number	:	217-709-2344

Provider Business Practice Location Address
First Line	:	313 W ESPERANZA BLVD
Second Line	:
City	:	GREEN VALLEY
State	:	AZ
Zip	:	85614-2708
Country	:	US
Telephone Number	:	520-648-2417
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	:	06/16/2025

Similar Medicare Providers

1659601904 — DR. KATHY JO STONE PHARM D / MT ASCP
Practice Location Address:

313 W ESPERANZA BLVD
GREEN VALLEY, AZ
85614-2708

Practice Phone: 520-648-2417
Practice Fax: 520-625-5118

1275848343 — MRS. SYLVIA ADONICA LEE
Practice Location Address:

313 W ESPERANZA BLVD
GREEN VALLEY, AZ
85614-2708

Practice Phone: 520-648-2417
Practice Fax: 520-625-5118

1225073588 — VALLEY ASSOCIATED UROLOGY MEDICARE GROUP INC
Practice Location Address:

200 COTTAGE AVE , STE 101
MANTECA, CA
95336-4935

Practice Phone: 209-239-2197
Practice Fax: 209-239-7672

1255446837 — CAROLINA'S MEDICAL ALLIANCE
Practice Location Address:

636 GREEN ST
KINGSTREE, SC
29556-2708

Practice Phone: 843-354-3572
Practice Fax:

1992595516 — PEAK WELLNESS PT LLC
Practice Location Address:

2708 PALACE GREEN RD
KNOXVILLE, TN
37924-1154

Practice Phone: 423-200-6970
Practice Fax:

1295626414 — KASANDRA OSTRANDER NP
Practice Location Address:

3124 W LEMAY AVE
WEST VALLEY CITY, UT
84119-2708

Practice Phone: 801-809-4267
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.