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Contact Information

WALGREEN CO
803 N BROADWAY AVE
WICHITA, KS67214
 Phone: 316-768-5450
 Fax: 316-768-5452
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
 

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
 

Durable Medical Equipment & Medical Supplies

332B00000X 54 Other Medical Supply Company
Indicates primary specialty

NPI Profile & details for WALGREEN CO

NPI Number 1417492174
LBN Legal business name WALGREEN CO
Authorized official JENNIFER PONCE - (MANAGER)
Entity Organization
Organization subpart 1 Yes
Enumeration date 01/04/2017
Last updated 06/25/2025 - About 11 months ago
Identifiers
KS License # 2-102089
KS Medicaid 100432220L
KS Other 1722051 NCPDP
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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