Organization
WALGREEN CO
Active
Parent organization
WALGREEN CO
Other names
WALGREENS #10107
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
633 W TIETAN ST, WALLA WALLA, WA 99362-4329
(509) 529-1570
(509) 529-5283
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
CF58766
WA
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4931982
NCPDP
—
05
—
6029482
—
WA
Enumeration date
10/02/2006
Last updated
02/09/2026
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