# WALGREEN CO

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Parent organization:** WALGREENS HOLDING COMPANY
- **Other names:** Walgreens \#12631
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1568779346
- **Legal business name:** WALGREENS HOLDING COMPANY
- **Authorized official:** JENNIFER PONCE (MANAGER)
- **Authorized official phone:** (847) 527-2489

## Contact information

- **Practice address:** 2084 STATE ROUTE 208, MONTGOMERY, NY 12549-2611
- **Practice address phone:** (845) 769-9203
- **Practice address fax:** (845) 769-9209
- **Mailing address:** 1901 E VOORHEES ST, MS 790, DANVILLE, IL 61834-4515
- **Mailing address phone:** (847) 527-2489
- **Mailing address fax:** (217) 709-2344

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 333600000X | Pharmacy | 030561 | NY | Yes |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 09/01/2010
- **Last updated:** 06/15/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 03379119 | — | NY |
| 01 | — | 5800962 | NCPDP | NY |