Organization · Type 2 NPI

Walgreen Co

Pharmacy · Manteca, CA

NPI number 1245245539 Active

Practice location

1071 N Main St
Manteca, CA 95336-3744

Call (209) 825-5481 Map

Fax (209) 825-6998

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	PHY37541 (CA)
Community/Retail Pharmacy	3336C0003X	PHY37541 (CA)

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…

7 other providers at this address

Other pharmacy providers in Manteca

See all in Manteca →

NPI record

NPI: 1245245539
Entity type: Organization (Type 2)
Issued: Jul 29, 2006
Last updated: Jun 9, 2026
Status: Active
Subpart: Yes of Walgreens Holding Company

Other names

<unavail>
Walgreens #10454 · doing business as
Walgreens #10454 · 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 1245245539

Walgreen Co's National Provider Identifier is 1245245539, issued on Jul 29, 2006. The primary taxonomy on file is Pharmacy (333600000X), and the practice location is in Manteca, CA. The record was last updated on Jun 9, 2026.