Organization · Type 2 NPI

Walgreen Co.

Pharmacy · Minneapolis, MN

NPI number 1013280403 Active

Practice location

2100 Lyndale Ave S Ste A
Minneapolis, MN 55405

Call (612) 872-7808 Map

Fax (612) 874-1084

Mailing address

1901 E Voorhees St
Danville, IL 61834-4515

Specialties and licenses

Taxonomy	Code	License
Durable Medical Equipment & Medical Supplies	332B00000X	None listed
Pharmacy Primary	333600000X	263842 (MN)
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…

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NPI record

NPI: 1013280403
Entity type: Organization (Type 2)
Issued: Feb 15, 2012
Last updated: Oct 19, 2026
Status: Active
Subpart: Yes of Walgreens Holding Company

Other names

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Walgreens Specialty Pharmacy #15309 · doing business as

Authorized official

Jennifer Ponce
Manager
(847) 527-2489

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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.

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About NPI 1013280403

Walgreen Co.'s National Provider Identifier is 1013280403, issued on Feb 15, 2012. The primary taxonomy on file is Pharmacy (333600000X), and the practice location is in Minneapolis, MN. The record was last updated on Oct 19, 2026.