Organization · Type 2 NPI

Walgreen Co

Pharmacy · Liberty Lake, WA

NPI number 1376718759 Active

Practice location

1502 N Liberty Lake Rd
Liberty Lake, WA 99019-8631

Call (509) 570-0485 Map

Fax (509) 570-0491

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	CF60021723 (WA)
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…

6 other providers at this address

Other pharmacy providers in Liberty Lake

Well Life Compounding LLCPharmacy Liberty Lake, WA NPI 1467878389

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NPI record

NPI: 1376718759
Entity type: Organization (Type 2)
Issued: Apr 25, 2008
Last updated: Aug 26, 2026
Status: Active
Subpart: Yes of Walgreens Holding Company

Other names

<unavail>
Walgreens #10788 · doing business as
Walgreens #10788 · 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 1376718759

Walgreen Co's National Provider Identifier is 1376718759, issued on Apr 25, 2008. The primary taxonomy on file is Pharmacy (333600000X), and the practice location is in Liberty Lake, WA. The record was last updated on Aug 26, 2026.