Walgreen Co
Pharmacy in Oklahoma City, OK. Organization (NPI-2).
NPI number1790790764
StatusActive
Last updated in NPPESOct 14, 2026
Details
- NPI
- 1790790764
- Entity type
- Organization (NPI-2)
- Legal business name
- Walgreen Co
- Organization subpart
- Yes
- Enumeration date
- Jul 29, 2006
- Certification date
- Oct 14, 2026
- Last updated
- Oct 14, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 333600000X | Pharmacy | 1-4197 | OK | Yes |
| 332B00000X | Durable Medical Equipment & Medical Supplies | – | – | |
| 3336C0003X | Pharmacy, Community/Retail Pharmacy | – | – |
Other names
- Walgreens #04111 (Doing Business As)
Practice location
12240 N May AveOklahoma City, OK 73120-6803
Phone 405-751-1938
Mailing address
1901 E Voorhees St # Ms 790Danville, IL 61834-4515
Phone 847-527-2489 · Fax 217-709-2344
Authorized official
Jennifer Ponce
Manager
8475272489
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