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NPI Code Detail

MEDICARE: WALGREEN CO

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
1332B00000XDurable Medical Equipment & Medical Supplies
2333600000XPharmacy2009007931MO
33336C0002XClinic Pharmacy

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
22638368OTHERMONCPDP

General Provider Information

NPI Number : 1972748226
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 : 2340 HAMPTON AVE
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63139-2935
Country : US
Telephone Number : 314-647-1256
Fax Number : 314-644-0924
Authorized Official
Title or Position : MANAGER
Name : JENNIFER PONCE
Credential :
Telephone Number : 847-527-2489
Provider Enumeration Date : 12/15/2008
Last Update Date : 11/06/2024

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Directions to “WALGREEN CO ” Practice Location

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