Walgreen Co
Pharmacy in Waupun, WI. Organization (NPI-2).
NPI number1013178367
StatusActive
Last updated in NPPESMay 29, 2026
Details
- NPI
- 1013178367
- Entity type
- Organization (NPI-2)
- Legal business name
- Walgreen Co
- Organization subpart
- Yes
- Enumeration date
- Jun 19, 2008
- Certification date
- May 29, 2026
- Last updated
- May 29, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 333600000X | Pharmacy | 8860-042 | WI | Yes |
| 332B00000X | Durable Medical Equipment & Medical Supplies | – | – | |
| 3336C0003X | Pharmacy, Community/Retail Pharmacy | – | – |
Other names
- Walgreens #11649 (Doing Business As)
Practice location
999 E Main StWaupun, WI 53963-2210
Phone 920-324-4696 · Fax 920-324-4910
Mailing address
1901 E Voorhees StMs 790
Danville, IL 61834-4515
Phone 847-527-2489 · Fax 217-709-2344
Authorized official
Jennifer Ponce
Manager
8475272489
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
Checking a whole list?
Paste up to 5,000 NPIs and download status, name, taxonomy, license and address for each one. Useful for credentialing, billing and pharmacy claim checks.