Active NPI
Walgreen Co
Doing business as The Living Well Pharmacy Submixer
- Pharmacy
- Redmond, WA
National Provider Identifier
1942092093
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- Legal business name
- WALGREEN CO
- Doing business as
- The Living Well Pharmacy Submixer
- Practice address
- 15253 NE 40TH St Ste 101
Redmond, WA 98052-5310 - Phone
- (425) 202-9008
- NPI assigned
- May 22, 2025
- Last updated
- May 22, 2025
- Organization subpart
- Yes
- Parent organization
- WALGREENS BOOTS ALLIANCE INC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jennifer Ponce
- Title
- Manager
- Phone
- (224) 475-5702
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | Primary | ||
| Community/Retail Pharmacy | 3336C0003X |
Addresses
Primary practice location
15253 NE 40TH St Ste 101
Redmond, WA 98052-5310
Mailing address
1901 E Voorhees St # Ms 790
Danville, IL 61834-4515
Phone (217) 709-2494
Other names 1
- The Living Well Pharmacy Submixer
National Provider Directory
National Provider Directory- Tax ID family
- Walgreen Co
- Part of
- Walgreens Holding Company
Organizations with this tax ID in the same state 14
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
Locations
15253 NE 40th St
Ste 101
Redmond, WA 98052
Phone (425) 202-9008
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1747872000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1747872000000",
"number": "1942092093",
"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": "217-709-2494"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15253 NE 40TH ST STE 101",
"city": "REDMOND",
"state": "WA",
"postal_code": "980525310",
"telephone_number": "425-202-9008"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WALGREEN CO",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "WALGREENS BOOTS ALLIANCE INC",
"enumeration_date": "2025-05-22",
"last_updated": "2025-05-22",
"certification_date": "2025-05-22",
"status": "A",
"authorized_official_last_name": "PONCE",
"authorized_official_first_name": "JENNIFER",
"authorized_official_title_or_position": "MANAGER",
"authorized_official_telephone_number": "224-475-5702"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": false
},
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": null,
"license": null,
"primary": true
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "The Living Well Pharmacy Submixer",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Redmond, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.