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	291U00000X	Clinical Medical Laboratory
3	3336C0003X	Community/Retail Pharmacy
4	333600000X	Pharmacy	20383	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	4513140	OTHER	OTHER ID NUMBER-COMMERCIAL NUMBER
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1932116852
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	:	7930 BELT LINE RD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75254-8130
Country	:	US
Telephone Number	:	972-716-0937
Fax Number	:

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

Provider Enumeration Date	:	08/02/2006
Last Update Date	:	04/22/2026

Similar Medicare Providers

1194052274 — DR. NIVEN HIDELL PHARMD
Practice Location Address:

7930 BELT LINE RD
DALLAS, TX
75254-8130

Practice Phone: 972-716-0937
Practice Fax:

1134594799 — CORBIN CARLSON
Practice Location Address:

7930 BELT LINE RD
DALLAS, TX
75254-8130

Practice Phone: 972-716-0937
Practice Fax:

1831674555 — IMANI CROSBY
Practice Location Address:

7910 BELT LINE RD
DALLAS, TX
75254-8130

Practice Phone: 972-980-6753
Practice Fax:

1841803228 — SAMER HADROUS PHARMD
Practice Location Address:

7930 BELT LINE RD
DALLAS, TX
75254-8130

Practice Phone: 972-716-0937
Practice Fax:

1578890810 — JAMES ZUBIATE PHARMD
Practice Location Address:

7930 BELTLINE RD
DALLAS, TX
75240-8130

Practice Phone: 972-716-0937
Practice Fax: 972-716-2088

1740710094 — ADORA 9 OPERATIONS, LLC
Practice Location Address:

8130 MEADOW ROAD
DALLAS, TX
75231

Practice Phone: 318-355-5803
Practice Fax: 505-369-0113

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.