Organization · NPI-2
Walgreen Co
Pharmacy · Eagle River, AK
NPI number1104166479
StatusActive
Last updated in NPPESAug 27, 2026
Details
- NPI
- 1104166479
- Entity type
- Organization (NPI-2)
- Legal business name
- Walgreen Co
- Organization subpart
- Yes
- Enumeration date
- Feb 25, 2013
- Certification date
- Aug 27, 2026
- Last updated
- Aug 27, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 333600000X | Pharmacy | 485 | AK | Yes |
| 332B00000X | Durable Medical Equipment & Medical Supplies | – | – | |
| 3336C0003X | Pharmacy, Community/Retail Pharmacy | – | – |
Other names
- Walgreens #15362 (Doing Business As)
Practice location
12051 Old Glenn HwyEagle River, AK 99577-7736
Phone 907-696-4000 · Fax 907-696-4001
Mailing address
1901 E Voorhees StMs #790
Danville, IL 61834-4509
Phone 847-527-2489 · Fax 217-709-2344
Authorized official
Jennifer Ponce
Manager
8475272489
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