<Unavail>

LBN: Walgreen Co
<Unavail> is an health care organization with primary practice located at 607 Park Ave , Beaver Dam WI 53916-2201. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Pharmacy is the primary health care specialty. Walgreen Co can be contacted via phone (920) 356-0148, or through Ponce, Jennifer via phone (847) 527-2489.

Contact Information

Primary practice address
607 Park Ave Beaver Dam WI 53916-2201
Phone: (920) 356-0148
Fax: (920) 356-0401
Website:
Map and Directions
Authorized official contact:
Name: Ponce, Jennifer
Phone: (847) 527-2489

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Pharmacy 333600000X 8776-042 Wisconsin
Suppliers / Community/Retail Pharmacy 3336C0003X

Profile Details

NPI number 1124210166
LBN Legal business name Walgreen Co
DBA Doing business as <Unavail>
Authorized official Ponce, Jennifer
Entity Organization
Organization subpart 1 Yes
Enumeration date Aug 14th, 2007
Last updated Jan 12th, 2026 - about 10 months ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1124210166 NPPES
Wisconsin MEDICAID 36221400
Wisconsin Other 5130098

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