NPIMap

Walgreen Co

Organization Active NPI Pharmacy · Lexington Park, MD

NPI 1356865299 · NPPES record last updated Feb 12, 2025

Key facts

NPI
1356865299
Entity type
Organization (NPI type 2)
Primary specialty
Pharmacy 333600000X
License
P07749 (MD)
Legal business name
WALGREEN CO
Practice address
21729 Great Mills Rd Ste C
Lexington Park, MD 20653-3815
Phone
(240) 895-8396
Fax
(240) 895-8397
NPI assigned
Aug 2, 2017
Organization subpart
Yes
Parent organization (as reported)
WALGREENS BOOTS ALLIANCE INC

Authorized official

Name
Jennifer Ponce
Title
Manager
Phone
(847) 527-2489

Corporate family (same tax ID) 24

Organizations that report the same tax identification number in the National Provider Directory.

Member of 16

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in TX

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20070917000779 TX Part B Supplier - Centralized Flu Biller 0941278253 This NPI is an additional NPI on the enrollment

National Provider Directory

Tax ID family
Walgreen Co (8,684 organizations share this tax ID)
Part of
Walgreens Holding Company

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X P07749 MD Yes
Community/Retail Pharmacy 3336C0003X

Addresses

Primary practice location

21729 Great Mills Rd Ste C
Lexington Park, MD 20653-3815

Mailing address

1901 E Voorhees St
Ms 790
Danville, IL 61834-4509
Phone (847) 527-2489

Other identifiers

IdentifierTypeStateIssuer
845116800MedicaidMD
2141620OtherMDNCPDP

Other names

  • Walgreens #17236 Doing business as

Other providers in Lexington Park, MD

All providers in Lexington Park, MD · Pharmacy in Maryland

Sources for this page

Verify at the official NPI Registry.