Walgreen Co
Organization Active NPI Pharmacy · Cartersville, GA
NPI 1962840967 · NPPES record last updated Oct 2, 2025
Key facts
- NPI
- 1962840967
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pharmacy 333600000X
- License
- PHRE009942 (GA)
- Legal business name
- WALGREEN CO
- Practice address
- 101 N Tennessee St
Cartersville, GA 30120-3211 - Phone
- (770) 387-2525
- Fax
- (770) 387-2531
- NPI assigned
- Jun 12, 2013
- Organization subpart
- Yes
- Parent organization (as reported)
- WALGREENS BOOTS ALLIANCE INC
Authorized official
- Name
- Jennifer Ponce
- Title
- Manager
- Phone
- (847) 527-2489
Other NPIs on the same Medicare enrollment 11
Corporate family (same tax ID) 16
Member of 16
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 11D2065333 | Walgreens #15180 | Certificate of waiver | Oct 11, 2027 |
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Walgreen Co |
Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order) | Accepts assignment |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (3 enrollments) in TX, GA
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 |
| O20131101001534 | GA | DME Supplier - Pharmacy | 0941278253 | Practice locations: Cartersville, GA |
| O20220825000936 | GA | Part B Supplier - Independent Clinical Laboratory | 0941278253 |
11 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Manchester, GA; Thomasville, GA; Peachtree City, GA; Nashville, GA; Midland, GA; Homerville, GA; Hogansville, GA; Hawkinsville, GA… |
National Provider Directory
- Tax ID family
- Walgreen Co
- Part of
- Walgreens Holding Company
Locations
101 N Tennessee St
Cartersville, GA 30120
Phone (770) 387-2525
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | PHRE009942 | GA | Yes |
| Community/Retail Pharmacy | 3336C0003X |
Addresses
Primary practice location
101 N Tennessee St
Cartersville, GA 30120-3211
Mailing address
1901 E Voorhees St
Ms 790
Danville, IL 61834-4515
Phone (847) 527-2489
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1163550 | Other | GA | NCPDP |
| 003137982A | Medicaid | GA |
Other names
- Walgreens #15180
NPI Registry JSON
{
"created_epoch": "1370995200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1759363200000",
"number": "1962840967",
"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": "101 N TENNESSEE ST",
"city": "CARTERSVILLE",
"state": "GA",
"postal_code": "301203211",
"telephone_number": "770-387-2525",
"fax_number": "770-387-2531"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WALGREEN CO",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "WALGREENS BOOTS ALLIANCE INC",
"enumeration_date": "2013-06-12",
"last_updated": "2025-10-02",
"certification_date": "2025-10-02",
"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": "GA",
"license": "PHRE009942",
"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": "NCPDP",
"identifier": "1163550",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "003137982A",
"state": "GA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Walgreens #15180",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Walgreens #15180",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Cartersville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 2, 2025. 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.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.