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Organization
WALGREEN CO
Active
Organization
WALGREEN CO
Active
Parent organization
WALGREENS HOLDING COMPANY
Other names
Walgreens Specialty Pharmacy #12470
Organization subpart
Yes
Provider details
NPI number
Legal business name
WALGREENS HOLDING COMPANY
Authorized official
JENNIFER PONCE (MANAGER)
(847) 527-2489
Entity
Organization
Contact information
Practice address
330 N WABASH AVE STE 100, MARION, IN 46952-2677
(765) 664-2247
(765) 664-2328
Mailing address
1901 E VOORHEES ST, MS #790, DANVILLE, IL 61834-4509
(847) 527-2489
(217) 709-2344
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
60006116A
IN
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1561895
NCPDP
—
05
—
200889010A
—
IN
05
—
7100240680
—
KY
Enumeration date
12/13/2007
Last updated
06/15/2026
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