Walgreen Co

Primary specialty

PharmacyTaxonomy code 333600000X

License

05239012 Issued in MS

Legal business name

WALGREEN CO

Practice address

6970 Old Canton Rd
Ridgeland, MS 39157-1229

Phone

(601) 956-3844

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 3

Addresses

Other identifiers 2

Other names 1

• WALGREENS #05655 Doing business as

Medicare fee-for-service enrollment

Enrolled in TX, MS3 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
  • Eupora, MS
  • NPI 1013096783
  NPD tax ID
• Walgreen Co

  • Pharmacy
  • Waynesboro, MS
  • NPI 1013168053
  NPD tax ID
• Walgreen Co

  • Pharmacy
  • Jackson, MS
  • NPI 1013922277
  NPD tax ID
• Walgreen Co

  • Pharmacy
  • Richland, MS
  • NPI 1023023264
  NPD tax ID
• Walgreen Co

  • Pharmacy
  • Horn Lake, MS
  • NPI 1063428530
  NPD tax ID
• Walgreen Co

  • Pharmacy
  • Brookhaven, MS
  • NPI 1093720252
  NPD tax ID
• Walgreen Co

  • Pharmacy
  • Long Beach, MS
  • NPI 1114932357
  NPD tax ID
• Walgreen Co

  • Pharmacy
  • Ellisville, MS
  • NPI 1144576182
  NPD tax ID
• Walgreen Co

  • Pharmacy
  • Ocean Springs, MS
  • NPI 1144743238
  NPD tax ID
• Walgreen Co

  • Pharmacy
  • Jackson, MS
  • NPI 1154337624
  NPD tax ID
• Walgreen Co

  • Pharmacy
  • Vicksburg, MS
  • NPI 1164945374
  NPD tax ID
• Walgreen Co

  • Pharmacy
  • Picayune, MS
  • NPI 1174531065
  NPD tax ID

Member of 16

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

• 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
• Walgreen Co

  • Pharmacy
  • Rio Rancho, NM
  • NPI 1528073426

  Member Of

  NPD member

Locations

All facility ownership & control disclosures 77

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

Practitioners 6

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

• Miriam Danielle Carter, PHARMD

  • Pharmacist
  • Ridgeland, MS
  • NPI 1114782042
  NPD (past)
• Ramona Raschelle Cork

  • Pharmacist
  • Ridgeland, MS
  • NPI 1275145849
  NPD (past)
• Matthew Raymond Illich, PHARMD

  • Pharmacist
  • Gulfport, MS
  • NPI 1558972307
  NPD (past)
• Jagroop Kaur

  • Pharmacist
  • Ridgeland, MS
  • NPI 1780458406
  NPD (past)
• Olivia Strain, PHARM.D.

  • Pharmacist
  • Ridgeland, MS
  • NPI 1891072484
  NPD (past)
• Rachel Thompson

  • Pharmacist
  • Ridgeland, MS
  • NPI 1053747097
  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": "1757030400000",
    "number": "1194730358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 E VOORHEES ST",
            "address_2": "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": "6970 OLD CANTON RD",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391571229",
            "telephone_number": "601-956-3844"
        }
    ],
    "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": "2025-09-05",
        "certification_date": "2025-09-05",
        "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": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "MS",
            "license": "05239012",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "2520763",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00330646",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WALGREENS #05655",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "WALGREENS #05655",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lateshia McDade Vincent, OTR-L
• Virtue Standards LLC
• Vocational Solutions and Consulting Services LLC
• Wal-Mart Stores East LP
• Wal-Mart Stores East, LP
• Walgreen Co
• Jay Evan Walker, COTA-L
• William Bryant Walker, MD
• Melanie Jordan Wall
• Brian Venson Wallace, DPT

• Pharmacy in Ridgeland, MS
• Providers in Ridgeland, MS by specialty
• Pharmacy in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 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.