WALGREEN CO NPI 1184963860

NPI Information

  • NPI: 1184963860
  • Provider Name: WALGREEN CO
  • Classification: Pharmacy - 333600000X
  • Entity Type: Organization
  • :
  • CLIA Number: 45D2013369
  • Address: 3080 COLLEGE ST STE 1
    BEAUMONT, TX
    ZIP 77701
  • Phone: (409) 813-1206

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NPI Details

WALGREEN CO is a pharmacy in Beaumont, TX. The provider is a facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. WALGREEN CO NPI is 1184963860. The provider is registered as an organization entity type.
The provider .

The provider's business location address is:

3080 COLLEGE ST STE 1
BEAUMONT, TX
ZIP 77701-606
Phone: (409) 813-1206
Fax: (409) 813-1261

The provider's authorized official is Jennifer Ponce .
The authorized official title is Manager and has the following contact phone number (847) 527-2489.

The CLIA number assigned to this NPI record is 45D2013369 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/31/2013 and was last updated on 6/25/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1332B00000XDurable Medical Equipment & Medical SuppliesNo
23336C0003XPharmacyCommunity/Retail PharmacyNo
3333600000XPharmacyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1468575MEDICAIDTEXAS
25907982OTHERTEXASNCPDP

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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