Organization · Type 2 NPI

Walgreen Co

Pharmacy · Mooresville, NC

NPI number 1114156510 Active

Practice location

1114 Brawley School Rd
Mooresville, NC 28117-5937

Call (704) 696-2583 Map

Fax (704) 696-2597

Mailing address

1901 E Voorhees St, Ms 790
Danville, IL 61834-4515

Specialties and licenses

Taxonomy	Code	License
Durable Medical Equipment & Medical Supplies	332B00000X	None listed
Pharmacy Primary	333600000X	10332 (NC)
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…

2 other providers at this address

Other pharmacy providers in Mooresville

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NPI record

NPI: 1114156510
Entity type: Organization (Type 2)
Issued: Jul 7, 2009
Last updated: May 29, 2026
Status: Active
Subpart: Yes of Walgreens Boots Alliance Inc

Other names

<unavail>
Walgreens #11892 · doing business as
Walgreens #11892 · 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 1114156510

Walgreen Co's National Provider Identifier is 1114156510, issued on Jul 7, 2009. The primary taxonomy on file is Pharmacy (333600000X), and the practice location is in Mooresville, NC. The record was last updated on May 29, 2026.