Walgreen Co

Primary specialty

PharmacyTaxonomy code 333600000X

License

19113 Issued in TX

Legal business name

WALGREEN CO

Practice address

1520 S Valley Mills Dr
Beverly Hills, TX 76711-1607

Phone

(254) 752-3986

NPI assigned

Jul 29, 2006

Organization subpart

Yes

Parent organization

WALGREENS BOOTS ALLIANCE INCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jennifer Ponce

Title

Manager

Phone

(847) 527-2489

Specialties & licenses 4

Addresses

Other identifiers 3

Other names 1

• WALGREENS #04607 Doing business as

Medicare fee-for-service enrollment

Enrolled in TX3 enrollments

Enrollment records 3

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Medicare medical equipment & supply locations

Tax ID family

Walgreen Co8,684 organizations share this tax ID, including this one

Part of

Walgreens Holding Company

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

• Walgreen Co

  • Pharmacy
  • Palestine, TX
  • NPI 1003595646
  NPD tax ID
• Walgreen Co

  • Pharmacy
  • Port Arthur, TX
  • NPI 1003821018
  NPD tax ID
• Walgreen Co

  • Pharmacy
  • Brownsville, TX
  • NPI 1003821026
  NPD tax ID
• Walgreen Co

  • Pharmacy
  • Irving, TX
  • NPI 1003821034
  NPD tax ID
• Walgreen Co

  • Pharmacy
  • Dickinson, TX
  • NPI 1003823071
  NPD tax ID
• Walgreen Co

  • Pharmacy
  • Bryan, TX
  • NPI 1003823980
  NPD tax ID
• Walgreen Co

  • Pharmacy
  • Harker Heights, TX
  • NPI 1013055938
  NPD tax ID
• Walgreen Co

  • Pharmacy
  • Athens, TX
  • NPI 1013696657
  NPD tax ID
• Walgreen Co

  • Pharmacy
  • San Antonio, TX
  • NPI 1013714971
  NPD tax ID
• Walgreen Co

  • Pharmacy
  • Richardson, TX
  • NPI 1013922046
  NPD tax ID
• Walgreen Co

  • Pharmacy
  • Crosby, TX
  • NPI 1013922079
  NPD tax ID
• Walgreen Co

  • Pharmacy
  • Dallas, TX
  • NPI 1023023009
  NPD tax ID

Member of 16

Organizations this organization is a member of, according to the National Provider Directory.

• Walgreens Specialty Pharmacy LLC

  • Pharmacy
  • Frisco, TX
  • NPI 1851463087

  Member Of

  NPD member
• Cypress Home Medical Inc

  • Home Infusion Therapy Pharmacy
  • Fort Myers, FL
  • NPI 1437188315

  Member Of

  NPD member
• Healthcare Options of Minnesota, Inc.

  • Home Infusion Therapy Pharmacy
  • Sauk Rapids, MN
  • NPI 1891746111

  Member Of

  NPD member
• I.V. Associates, Inc.

  • Home Infusion Therapy Pharmacy
  • Eatontown, NJ
  • NPI 1811940810

  Member Of

  NPD member
• Mednow Infusion, LLC

  • Home Infusion Agency
  • Meridian, ID
  • NPI 1225645526

  Member Of

  NPD member
• Option Care at Legacy Health LLC

  • Home Infusion Therapy Pharmacy
  • Bend, OR
  • NPI 1174875017

  Member Of

  NPD member
• Option Care Enterprises, Inc.

  • Home Infusion Therapy Pharmacy
  • Chantilly, VA
  • NPI 1679896989

  Member Of

  NPD member
• Option Care Home Care, Inc.

  • Home Infusion Agency
  • Wauwatosa, WI
  • NPI 1396343471

  Member Of

  NPD member
• Option Care Infusion Services, LLC

  • Home Infusion Therapy Pharmacy
  • Nashville, TN
  • NPI 1326279746

  Member Of

  NPD member
• TSL Inc

  • Home Infusion Therapy Pharmacy
  • Merrillville, IN
  • NPI 1942269956

  Member Of

  NPD member
• Walgreen Co

  • Pharmacy
  • Wilmington, DE
  • NPI 1093738643

  Member Of

  NPD member
• Walgreen Co

  • Pharmacy
  • Phoenix, AZ
  • NPI 1356356695

  Member Of

  NPD member

All facility ownership & control disclosures 77

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mahmud Hasanrafi Haque, RPH

  • Pharmacist
  • Beverly Hills, TX
  • NPI 1407467574
  NPD (past)
• Das Hey Kang

  • Pharmacist
  • Beverly Hills, TX
  • NPI 1316559867
  NPD (past)
• Mark Rasband, PHARM D

  • Pharmacist
  • Beverly Hills, TX
  • NPI 1316338106
  NPD (past)
• Arthur F Smith

  • Pharmacist
  • Beverly Hills, TX
  • NPI 1265769111
  NPD (past)
• Clenny Edward Terrell, RPH

  • Pharmacist
  • Bevely Hills, TX
  • NPI 1053606228
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750118400000",
    "number": "1013922178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 E VOORHEES ST # MS 790",
            "city": "DANVILLE",
            "state": "IL",
            "postal_code": "618344515",
            "telephone_number": "847-527-2489",
            "fax_number": "217-709-2344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 S VALLEY MILLS DR",
            "city": "BEVERLY HILLS",
            "state": "TX",
            "postal_code": "767111607",
            "telephone_number": "254-752-3986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALGREEN CO",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WALGREENS BOOTS ALLIANCE INC",
        "enumeration_date": "2006-07-29",
        "last_updated": "2025-06-17",
        "certification_date": "2025-06-17",
        "status": "A",
        "authorized_official_last_name": "PONCE",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "847-527-2489"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "TX",
            "license": "19113",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "464210",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "4532621",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "469226",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WALGREENS #04607",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "WALGREENS #04607",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mahmud Hasanrafi Haque, RPH
• Das Hey Kang
• Mona Patel Petigara, RPH
• Mark Rasband, PHARM D
• Arthur F Smith

• Pharmacy in Beverly Hills, TX
• Providers in Beverly Hills, TX by specialty
• Pharmacy in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.