Organization · Type 2 NPI

Walgreen Co

Pharmacy · Bristol, TN

NPI number 1134431620 Active

Practice location

1 Medical Park Blvd Ste 106E
Bristol, TN 37620-7450

Call (423) 844-2888 Map

Fax (423) 844-0539

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	None listed
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 Bristol

See all in Bristol →

NPI record

NPI: 1134431620
Entity type: Organization (Type 2)
Issued: Jul 13, 2010
Last updated: Jun 15, 2026
Status: Active
Subpart: Yes of Walgreens Holding Company

Other names

<unavail>
Walgreens Specialty Pharmacy #13979 · 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 1134431620

Walgreen Co's National Provider Identifier is 1134431620, issued on Jul 13, 2010. The primary taxonomy on file is Pharmacy (333600000X), and the practice location is in Bristol, TN. The record was last updated on Jun 15, 2026.