Organization · Type 2 NPI

Walgreen Co

Pharmacy · Bridgeport, CT

NPI number 1205842945 Active

Practice location

4083 Main St
Bridgeport, CT 06606-2302

Call (203) 374-2819 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	1855 (CT)
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 Bridgeport

See all in Bridgeport →

NPI record

NPI: 1205842945
Entity type: Organization (Type 2)
Issued: Aug 1, 2006
Last updated: Oct 13, 2026
Status: Active
Subpart: Yes of Walgreens Holding Company

Other names

<unavail>
Walgreens #07522 · doing business as
Walgreens #07522 · 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 1205842945

Walgreen Co's National Provider Identifier is 1205842945, issued on Aug 1, 2006. The primary taxonomy on file is Pharmacy (333600000X), and the practice location is in Bridgeport, CT. The record was last updated on Oct 13, 2026.