Organization · Type 2 NPI

Walgreen Co

Pharmacy · Gray, TN

NPI number 1003002254 Active

Practice location

5104 Bobby Hicks Hwy
Gray, TN 37615-6217

Call (423) 477-3372 Map

Fax (423) 477-8533

Mailing address

1901 E Voorhees St, Ms #790
Danville, IL 61834-4509

Specialties and licenses

Taxonomy	Code	License
Durable Medical Equipment & Medical Supplies	332B00000X	None listed
Pharmacy Primary	333600000X	4444 (TN)
Community/Retail Pharmacy	3336C0003X	None listed

Pharmacy: 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 lo…

6 other providers at this address

NPI record

NPI: 1003002254
Entity type: Organization (Type 2)
Issued: Sep 21, 2007
Last updated: May 5, 2025
Status: Active
Subpart: Yes of Walgreens Boots Alliance Inc

Other names

<unavail>
Walgreens #11113 · doing business as
Walgreens #11113 · doing business as

Authorized official

Jennifer Ponce
Manager
(847) 527-2489

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

Is this your record? How to update it.

About NPI 1003002254

Walgreen Co's National Provider Identifier is 1003002254, issued on Sep 21, 2007. The primary taxonomy on file is Pharmacy (333600000X), and the practice location is in Gray, TN. The record was last updated on May 5, 2025.