Walgreen Co

Primary specialty

PharmacyTaxonomy code 333600000X

License

5301007073 Issued in MI

Legal business name

WALGREEN CO

Practice address

11635 E 13 Mile Rd
Warren, MI 48093-3021

Phone

(586) 446-0853

NPI assigned

Jul 29, 2006

Organization subpart

Yes

Parent organization

WALGREENS HOLDING COMPANYAs 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 3

Other names 1

• WALGREENS #05322 Doing business as

Medicare fee-for-service enrollment

Enrolled in TX, MI3 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
  • Wyoming, MI
  • NPI 1447265558
  NPD tax ID
• Walgreen Co

  • Pharmacy
  • Escanaba, MI
  • NPI 1447265749
  NPD tax ID
• Walgreen Co

  • Pharmacy
  • Allendale, MI
  • NPI 1447446711
  NPD tax ID
• Walgreen Co

  • Pharmacy
  • Lowell, MI
  • NPI 1447480835
  NPD tax ID
• Walgreen Co

  • Pharmacy
  • Eastpointe, MI
  • NPI 1457366577
  NPD tax ID
• Walgreen Co

  • Pharmacy
  • Coldwater, MI
  • NPI 1457366585
  NPD tax ID
• Walgreen Co

  • Pharmacy
  • Greenville, MI
  • NPI 1457366759
  NPD tax ID
• Walgreen Co

  • Pharmacy
  • Southfield, MI
  • NPI 1457368474
  NPD tax ID
• Walgreen Co

  • Pharmacy
  • Saint Clair Shores, MI
  • NPI 1467467589
  NPD tax ID
• Walgreen Co

  • Pharmacy
  • Fraser, MI
  • NPI 1467467753
  NPD tax ID
• Walgreen Co

  • Pharmacy
  • Detroit, MI
  • NPI 1467943852
  NPD tax ID
• Walgreen Co

  • Pharmacy
  • Livonia, MI
  • NPI 1477560464
  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

All facility ownership & control disclosures 77

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

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

{
    "created_epoch": "1154131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780444800000",
    "number": "1477568509",
    "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": "11635 E 13 MILE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480933021",
            "telephone_number": "586-446-0853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALGREEN CO",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WALGREENS HOLDING COMPANY",
        "enumeration_date": "2006-07-29",
        "last_updated": "2026-06-03",
        "certification_date": "2026-06-03",
        "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": "MI",
            "license": "5301007073",
            "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": "2360244",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4809830 DME",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4161805",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WALGREENS #05322",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "WALGREENS #05322",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Roberta Walden
• Alexandra Waldman
• Caitlin Waldorf, LMSW
• Walgreen Co
• Walgreen Co
• Walgreen Co
• Walgreens
• Mohammed Mehdi Walji, MD
• Lacey Walke, M.D.
• Andrea Walker

• Pharmacy in Warren, MI
• Providers in Warren, MI by specialty
• Pharmacy in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2026; 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.