National Provider Identifier Database

WALGREEN CO
Pharmacy

A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.


Contact Information

WALGREEN CO
631 PROFESSIONAL DR STE 100
LAWRENCEVILLE, GA30046
Phone: 770-339-2029
Fax: 770-339-7385
Website:
Specialty Taxonomy Code
* Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X
Durable Medical Equipment & Medical Supplies 332B00000X

* Indicates primary specialty

NPI Profile & details for WALGREEN CO

NPI Number 1477847275
Legal business name
LBN
WALGREEN CO
Authorized official JENNIFER PONCE - (MANAGER)
Entity Organization
Organization subpart Yes
Enumeration date 06/09/2011
Last updated 11/26/2024 - More than a year ago
Sole proprietor1 Not specified
Identifiers
  • GA License #: PHRE009774
  • GA Medicaid: 003113828A
  • SC Medicaid: 7G9774
  • GA Other: 1161544 NCPDP

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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