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	PHY46372	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	5630000	OTHER	OTHER ID NUMBER-COMMERCIAL NUMBER

General Provider Information

NPI Number	:	1942215041
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	:	3331 W CENTURY BLVD
Second Line	:
City	:	INGLEWOOD
State	:	CA
Zip	:	90303-1366
Country	:	US
Telephone Number	:	310-671-1523
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	:	05/29/2026

Similar Medicare Providers

1528379294 — DR. BRANDON C. MAY PHARM.D
Practice Location Address:

3331 W CENTURY BLVD
INGLEWOOD, CA
90303-1366

Practice Phone: 310-671-1523
Practice Fax:

1245508399 — BRENDA L NEAL
Practice Location Address:

3331 W CENTURY BLVD
INGLEWOOD, CA
90303-1366

Practice Phone: 310-671-1523
Practice Fax: 310-671-2179

1568074458 — GEORGE ESKANDER RPH
Practice Location Address:

3331 W CENTURY BLVD
INGLEWOOD, CA
90303-1366

Practice Phone: 310-671-1523
Practice Fax: 310-671-2179

1457955619 — DR. DIEP H NGUYEN PHARMACIST
Practice Location Address:

3331 W CENTURY BLVD
INGLEWOOD, CA
90303-1366

Practice Phone: 310-671-1523
Practice Fax:

1366374001 — ALEXANDRA MARIE GOMEZ PENA LVN
Practice Location Address:

3310 W CENTURY BLVD
INGLEWOOD, CA
90303-1305

Practice Phone: 323-765-6165
Practice Fax:

1619821717 — SUNDAY IFEANYI MADU
Practice Location Address:

11149 CRENSHAW BLVD
INGLEWOOD, CA
90303-2338

Practice Phone: 310-808-8494
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.