Organization · Type 2 NPI

Walgreen Co

Pharmacy · Daytona Beach, FL

NPI number 1124033311 Active

Practice location

100 S Ridgewood Ave
Daytona Beach, FL 32114-4316

Call (386) 255-4167 Map

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	PH21353 (FL)
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 Daytona Beach

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NPI record

NPI: 1124033311
Entity type: Organization (Type 2)
Issued: Jul 29, 2006
Last updated: Nov 19, 2025
Status: Active
Subpart: Yes of Walgreens Boots Alliance Inc

Other names

<unavail>
Walgreens #04423 · doing business as
Walgreens #04423 · 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 1124033311

Walgreen Co's National Provider Identifier is 1124033311, issued on Jul 29, 2006. The primary taxonomy on file is Pharmacy (333600000X), and the practice location is in Daytona Beach, FL. The record was last updated on Nov 19, 2025.