WALGREEN CO NPI 1629083654

NPI Record

The following NPI record includes the field values provided by the NPPES as well as the field definition as published in the Federal Register. The complete NPI record is also available for download in text, csv and xml formats.

Field Name Field Value Definition 1
NPI 1629083654 The country code in the location address of the provider being identified.
Entity Type Code 2 The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
Employer Identification Number EIN The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
Provider Organization Name Legal Business Name WALGREEN CO The date the provider was assigned a unique identifier (assigned an NPI).
Provider Other Organization Name Other name by which the organization provider is or has been known.
Provider Other Organization Name Type Code 6 The State code in the location of the provider being identified.
Provider First Line Business Practice Location Address 1000 CLUB VILLAGE DR The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City Name COLUMBIA Specifies whether the provider is part of a single-specialty or multi-specialty business group. The possible values are: 193200000X – Multi-Specialty Group or 193400000X – Single Specialty Group. This field helps distinguish the organizational structure of a provider group.
Provider Business Practice Location Address State Name MO The name of the organization provider. If the provider is an organization, this is the legal business name.
Provider Business Practice Location Address Postal Code 652034405 The city name in the location address of the provider being identified.
Provider Business Practice Location Address Country Code If outside U S US Code identifying the type of other name. Codes are: 1 = former name; 2 = professional name; 3 = doing business as (d/b/ a) name; 4 = former legal business name; 5 = other.
Provider Business Practice Location Address Telephone Number 5734498330 The telephone number associated with the location address of the provider being identified.
Provider Enumeration Date 7/29/2006 Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Last Update Date 8/4/2025 The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Authorized Official Last Name PONCE Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Authorized Official First Name JENNIFER The country code in the location address of the provider being identified.
Authorized Official Title or Position MANAGER The telephone number associated with the location address of the provider being identified.
Authorized Official Telephone Number 8475272489 The fax number associated with the location address of the provider being identified.
Healthcare Provider Taxonomy Code 1 332B00000X The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Healthcare Provider Primary Taxonomy Switch 1 N The telephone number associated with the location address of the provider being identified.
Healthcare Provider Taxonomy Code 2 3336C0003X The telephone number associated with the location address of the provider being identified.
Healthcare Provider Primary Taxonomy Switch 2 N The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Healthcare Provider Taxonomy Code 3 333600000X This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number 3 2002005186 The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Provider License Number State Code 3 MO Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Healthcare Provider Primary Taxonomy Switch 3 Y The State code in the location of the provider being identified.
Other Provider Identifier 1 605752104 An additional identifier number for the provider, either current or previously used. This may include IDs issued by health plans, state agencies, or other organizations. The value is collected from the NPI application or update form.
Other Provider Identifier Type Code 1 05 The date the provider was assigned a unique identifier (assigned an NPI).
Other Provider Identifier State 1 MO The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Other Provider Identifier 2 2634358 The name of the organization, agency, or health plan that assigned the additional provider identifier. This identifies who issued the number linked to Other Provider Identifier 1 (for example, a state Medicaid agency, Medicare, or a private insurance company).
Other Provider Identifier Type Code 2 01 Indicates whether the provider is a subpart of a larger organization. This is a single-character code: "Y" means the entity is an organizational subpart, while "N" means it is not. Subparts typically include hospital departments, clinics, or other distinct units that fall under a parent organization.
Other Provider Identifier Issuer 2 OTHER ID NUMBER-COMMERCIAL NUMBER This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
Other Provider Identifier 3 625752100 DME The middle name of the provider, if the provider is an individual.
Other Provider Identifier Type Code 3 05 The name prefix or salutation of the provider if the provider is an individual; for example, Mr., Mrs., or Corporal.
Other Provider Identifier State 3 MO The first name of the provider, if the provider is an individual.
Is Organization Subpart Y Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Parent Organization LBN WALGREENS BOOTS ALLIANCE INC The Legal Business Name (LBN) of the parent organization, if the provider is a subpart of a larger entity. This field identifies the official registered name of the parent company or organization under which the provider operates.
Parent Organization TIN The first name of the provider, if the provider is an individual.
NPI Certification Date 8/4/2025 The city name in the location address of the provider being identified.

(1) Field Definition Source-. Federal Register / Vol. 69, No. 15 / Friday, January 23, 2004 / Rules and Regulations - Part II Department of Health and Human Services Office of the Secretary 45 CFR Part 162 HIPAA Administrative Simplification: Standard Unique Health Identifier for Health Care Providers; Final Rule

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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

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

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