Organization
WALGREEN CO
Active
Parent organization
WALGREEN CO
Other names
WALGREENS #05328
Organization subpart
Yes
Provider details
NPI number
Legal business name
WALGREEN CO
Authorized official
JENNIFER PONCE (MANAGER)
(847) 527-2489
Entity
Organization
Contact information
Practice address
5545 CYPRESS GARDENS BLVD, WINTER HAVEN, FL 33884-2243
(863) 318-8656
Mailing address
1901 E VOORHEES ST, MS 790, DANVILLE, IL 61834-4515
(847) 527-2489
(217) 709-2344
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
PH0017030
FL
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
021896100
—
FL
05
—
021896101 DME
—
FL
01
—
1087407
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
07/29/2006
Last updated
01/30/2026
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