Walgreen Co
Organization Active NPI Pharmacy · Jackson, WI
NPI 1538347232 · NPPES record last updated Jul 26, 2024
Key facts
- NPI
- 1538347232
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pharmacy 333600000X
- License
- 8809-042 (WI)
- Legal business name
- WALGREEN CO
- Practice address
- N168W21330 Main St
Jackson, WI 53037-1104 - Phone
- (262) 677-1702
- Fax
- (262) 677-2524
- NPI assigned
- Feb 5, 2008
- Organization subpart
- Yes
- Parent organization (as reported)
- WALGREENS BOOTS ALLIANCE INC
Authorized official
- Name
- Virginia Garza
- Title
- Manager
- Phone
- (217) 709-2364
Corporate family (same tax ID) 24
Member of 16
Practitioners 4
-
Stephanie Balsman, PHARMD
-
Scott McLean Foley, PHARM.D
-
Jon Charles Oconnell, RPH
-
Mark Seip, R.PH.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (3 enrollments) in TX, WI
All facility ownership & control disclosures 77
| Facility | Type | Role | Since |
|---|---|---|---|
| At Home Care |
Home health agency | 5% Or Greater Indirect Ownership Interest (29%) | Apr 16, 2021 |
| Adoration Home Health and Hospice Care East Tennessee |
Home health agency | 5% Or Greater Indirect Ownership Interest (29%) | May 17, 2019 |
| Adoration Home Health |
Home health agency | 5% Or Greater Indirect Ownership Interest (20%) | Apr 16, 2021 |
| Adoration Home Health |
Home health agency | 5% Or Greater Indirect Ownership Interest (20%) | Apr 16, 2021 |
| Adoration Home Health Care Mississippi |
Home health agency | 5% Or Greater Indirect Ownership Interest (29%) | May 17, 2019 |
| Adoration Home Health |
Home health agency | 5% Or Greater Indirect Ownership Interest (20%) | Apr 16, 2021 |
| Option Care |
Home health agency | 5% Or Greater Direct Ownership Interest (49%) | Mar 31, 2015 |
| Adoration Home Health |
Home health agency | 5% Or Greater Indirect Ownership Interest (20%) | Apr 16, 2021 |
| Adoration Home Health |
Home health agency | 5% Or Greater Indirect Ownership Interest (20%) | Apr 16, 2021 |
| Adoration Home Health LLC |
Home health agency | 5% Or Greater Indirect Ownership Interest (29%) | Mar 5, 2019 |
| Adoration Home Health |
Home health agency | 5% Or Greater Indirect Ownership Interest (29%) | Apr 16, 2021 |
| @Heart Homecare |
Home health agency | 5% Or Greater Indirect Ownership Interest (29%) | Aug 1, 2022 |
| Adoration Home Health |
Home health agency | 5% Or Greater Indirect Ownership Interest (20%) | Apr 16, 2021 |
| Adoration Home Health Nashville South |
Home health agency | 5% Or Greater Indirect Ownership Interest (29%) | Jan 1, 2021 |
| Adoration Home Health Martin |
Home health agency | 5% Or Greater Indirect Ownership Interest (20%) | Jan 13, 2025 |
| Adoration Home Health McMinnville |
Home health agency | 5% Or Greater Indirect Ownership Interest (29%) | Jan 1, 2021 |
| Adoration Home Health |
Home health agency | 5% Or Greater Indirect Ownership Interest (29%) | Mar 1, 2020 |
| Adoration Home Health |
Home health agency | 5% Or Greater Indirect Ownership Interest (29%) | Mar 1, 2020 |
| Adoration Home Health |
Home health agency | 5% Or Greater Indirect Ownership Interest (29%) | Mar 1, 2020 |
| Adoration Home Health |
Home health agency | 5% Or Greater Indirect Ownership Interest (29%) | Mar 1, 2020 |
| Adoration Home Health |
Home health agency | 5% Or Greater Indirect Ownership Interest (29%) | Mar 1, 2020 |
| Adoration Home Health |
Home health agency | 5% Or Greater Indirect Ownership Interest (29%) | Jan 1, 2021 |
| Adoration Home Health and Hospice |
Home health agency | 5% Or Greater Indirect Ownership Interest (20%) | Dec 30, 2024 |
| Adoration Home Health Baltimore |
Home health agency | 5% Or Greater Indirect Ownership Interest (20%) | Jan 9, 2025 |
| Adoration Home Health |
Home health agency | 5% Or Greater Indirect Ownership Interest (29%) | Aug 20, 2023 |
| Adoration Home Health Marlboro |
Home health agency | 5% Or Greater Indirect Ownership Interest (20%) | Aug 20, 2023 |
| Adoration Home Health |
Home health agency | 5% Or Greater Indirect Ownership Interest (20%) | Mar 1, 2023 |
| Adoration Home Health |
Home health agency | 5% Or Greater Indirect Ownership Interest (20%) | Feb 17, 2023 |
| Adoration Home Health |
Home health agency | 5% Or Greater Indirect Ownership Interest (29%) | Sep 1, 2024 |
| Adoration Home Health Care Rhode Island |
Home health agency | 5% Or Greater Indirect Ownership Interest (20%) | Sep 1, 2025 |
| Hospice of North Alabama, LLC |
Hospice | 5% Or Greater Indirect Ownership Interest (20%) | Apr 16, 2021 |
| Hospice Home Care of Pine Bluff, LLC |
Hospice | 5% Or Greater Indirect Ownership Interest (29%) | Nov 1, 2021 |
| Adoration Home Health and Hospice Care Mississippi |
Hospice | 5% Or Greater Indirect Ownership Interest (29%) | May 17, 2019 |
| Hospice Home Care of Monticello |
Hospice | 5% Or Greater Indirect Ownership Interest (20%) | Nov 1, 2021 |
| Springhill Home Health & Hospice |
Hospice | 5% Or Greater Indirect Ownership Interest (20%) | Apr 16, 2021 |
| Compassioncare Hospice |
Hospice | 5% Or Greater Indirect Ownership Interest (20%) | Apr 16, 2021 |
| Grane Hospice Care |
Hospice | 5% Or Greater Indirect Ownership Interest (29%) | Apr 16, 2021 |
| Oasis Healthcare, Inc. |
Hospice | 5% Or Greater Indirect Ownership Interest (29%) | Apr 16, 2021 |
| Grane Hospice Care |
Hospice | 5% Or Greater Indirect Ownership Interest (20%) | Apr 16, 2021 |
| Allay Home & Hospice |
Hospice | 5% Or Greater Indirect Ownership Interest (20%) | Sep 2, 2021 |
| Hospice Home Care, LLC |
Hospice | 5% Or Greater Indirect Ownership Interest (20%) | Nov 1, 2021 |
| Adoration Hospice Care Mississippi |
Hospice | 5% Or Greater Indirect Ownership Interest (29%) | May 17, 2019 |
| Adoration Home Health and Hospice Care East Tennessee |
Hospice | 5% Or Greater Indirect Ownership Interest (29%) | May 17, 2019 |
| Apreva Hospice |
Hospice | 5% Or Greater Indirect Ownership Interest (20%) | Jan 30, 2024 |
| Ohio Valley Hospice |
Hospice | 5% Or Greater Indirect Ownership Interest (29%) | Apr 16, 2021 |
| Spring Valley Hospice, LLC |
Hospice | 5% Or Greater Indirect Ownership Interest (20%) | Nov 1, 2021 |
| Adoration Hospice |
Hospice | 5% Or Greater Indirect Ownership Interest (29%) | Apr 16, 2021 |
| Grane Hospice Care |
Hospice | 5% Or Greater Indirect Ownership Interest (20%) | Apr 16, 2021 |
| Athc - Hospice, LLC |
Hospice | 5% Or Greater Indirect Ownership Interest (20%) | Apr 16, 2021 |
| All Saints Hospice |
Hospice | 5% Or Greater Indirect Ownership Interest (29%) | Nov 1, 2021 |
| Sacred Journey Hospice, LLC |
Hospice | 5% Or Greater Indirect Ownership Interest (29%) | Dec 9, 2020 |
| Embrace Hospice |
Hospice | 5% Or Greater Indirect Ownership Interest (20%) | Apr 16, 2021 |
| Grane Hospice Care |
Hospice | 5% Or Greater Indirect Ownership Interest (29%) | Apr 16, 2021 |
| Abode Hospice of Colorado |
Hospice | 5% Or Greater Indirect Ownership Interest (29%) | Apr 16, 2021 |
| Abode Hospice of Colorado |
Hospice | 5% Or Greater Indirect Ownership Interest (29%) | Apr 16, 2021 |
| Hospice of the Midwest LLC |
Hospice | 5% Or Greater Indirect Ownership Interest (29%) | Apr 16, 2021 |
| Adoration Hospice |
Hospice | 5% Or Greater Indirect Ownership Interest (29%) | Mar 5, 2019 |
| Athc - Hospice, LLC |
Hospice | 5% Or Greater Indirect Ownership Interest (20%) | Apr 16, 2021 |
| Hospice of the Midwest |
Hospice | 5% Or Greater Indirect Ownership Interest (20%) | Apr 16, 2021 |
| Compassioncare Hospice Reno |
Hospice | 5% Or Greater Indirect Ownership Interest (29%) | Apr 16, 2021 |
| @Heart Hospice |
Hospice | 5% Or Greater Indirect Ownership Interest (29%) | Aug 1, 2022 |
| Embrace Hospice |
Hospice | 5% Or Greater Indirect Ownership Interest (20%) | Apr 16, 2021 |
| Spring Valley Hospice of Tupelo |
Hospice | 5% Or Greater Indirect Ownership Interest (20%) | Nov 1, 2021 |
| Abode Hospice of Colorado |
Hospice | 5% Or Greater Indirect Ownership Interest (29%) | Apr 16, 2021 |
| Embrace Hospice |
Hospice | 5% Or Greater Indirect Ownership Interest | Mar 5, 2019 |
| Sacred Journey Hospice, LLC |
Hospice | 5% Or Greater Indirect Ownership Interest (20%) | Dec 9, 2020 |
| Athc - Hospice, LLC |
Hospice | 5% Or Greater Indirect Ownership Interest (20%) | Apr 16, 2021 |
| Embrace Hospice |
Hospice | 5% Or Greater Indirect Ownership Interest | Mar 5, 2019 |
| Athc - Hospice, LLC |
Hospice | 5% Or Greater Indirect Ownership Interest (20%) | Apr 16, 2021 |
| Abode Hospice of Colorado |
Hospice | 5% Or Greater Indirect Ownership Interest (29%) | Apr 16, 2021 |
| Generations Hospice |
Hospice | 5% Or Greater Indirect Ownership Interest (20%) | Sep 2, 2021 |
| Adoration Hospice |
Hospice | 5% Or Greater Indirect Ownership Interest (29%) | Jun 1, 2021 |
| Adoration Home Health and Hospice |
Hospice | 5% Or Greater Indirect Ownership Interest (29%) | Sep 1, 2021 |
| Sacred Journey Hospice, LLC |
Hospice | 5% Or Greater Indirect Ownership Interest (29%) | Dec 9, 2020 |
| Hospice of the Midwest |
Hospice | 5% Or Greater Indirect Ownership Interest (29%) | Apr 16, 2021 |
| Adoration Hospice |
Hospice | 5% Or Greater Indirect Ownership Interest (29%) | Aug 20, 2023 |
| Haven Hospice |
Hospice | 5% Or Greater Indirect Ownership Interest (20%) | Sep 1, 2024 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070917000779 | TX | Part B Supplier - Centralized Flu Biller | 0941278253 | This NPI is an additional NPI on the enrollment |
| O20100930035800 | WI | DME Supplier - Pharmacy | 0941278253 | Practice locations: Jackson, WI |
| O20201209002957 | WI | Part B Supplier - Independent Clinical Laboratory | 0941278253 | This NPI is an additional NPI on the enrollment |
National Provider Directory
- Tax ID family
- Walgreen Co
- Part of
- Walgreens Holding Company
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | 8809-042 | WI | Yes |
| Community/Retail Pharmacy | 3336C0003X |
Addresses
Primary practice location
N168W21330 Main St
Jackson, WI 53037-1104
Mailing address
1901 E Voorhees St
Ms #790
Danville, IL 61834-4509
Phone (217) 709-2364
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5130454 | Other | NCPDP | |
| 36226200 | Medicaid | WI |
Other names
- Walgreens # 11676
Other providers in Jackson, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 26, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.