Organization · Type 2 NPI

Walgreen Co

Pharmacy · St. Augustine, FL

NPI number 1336396647 Active

Practice location

2801 N Ponce De Leon Blvd
St. Augustine, FL 32084-1648

Call (904) 810-2200 Map

Fax (904) 810-2292

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	PH23626 (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…

Another provider at this address

Jessie BushPharmacist St. Augustine, FL NPI 1346797735

Other pharmacy providers in St. Augustine

See all in St. Augustine →

NPI record

NPI: 1336396647
Entity type: Organization (Type 2)
Issued: Aug 19, 2008
Last updated: Oct 20, 2025
Status: Active
Subpart: Yes of Walgreens Boots Alliance Inc

Other names

<unavail>
Walgreens #11485 · doing business as
Walgreens #11485 · 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.

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About NPI 1336396647

Walgreen Co's National Provider Identifier is 1336396647, issued on Aug 19, 2008. The primary taxonomy on file is Pharmacy (333600000X), and the practice location is in St. Augustine, FL. The record was last updated on Oct 20, 2025.