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Contact Information

WALGREEN CO
2920 WHITE BEAR AVE N
MAPLEWOOD, MN55109
 Phone: 651-251-9938
 Fax:
 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 1457533143
LBN Legal business name WALGREEN CO
Authorized official JENNIFER PONCE - (MANAGER)
Entity Organization
Organization subpart 1 Yes
Enumeration date 12/04/2007
Last updated 11/19/2025 - About 7 months ago
Identifiers
MN License # 263168
MN Medicaid 151627000
MN Other 2428616 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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