Organization · Type 2 NPI

Walgreen Co

Pharmacy · Staten Island, NY

NPI number 1386990323 Active

Practice location

655 Rossville Ave
Staten Island, NY 10309-1718

Call (718) 967-2955 Map

Fax (718) 967-2978

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	031561 (NY)
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…

7 other providers at this address

Other pharmacy providers in Staten Island

See all in Staten Island →

NPI record

NPI: 1386990323
Entity type: Organization (Type 2)
Issued: Jul 27, 2012
Last updated: Jun 16, 2026
Status: Active
Subpart: Yes of Walgreens Holding Company

Other names

<unavail>
Walgreens #15160 · doing business as
Walgreens #15160 · 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 1386990323

Walgreen Co's National Provider Identifier is 1386990323, issued on Jul 27, 2012. The primary taxonomy on file is Pharmacy (333600000X), and the practice location is in Staten Island, NY. The record was last updated on Jun 16, 2026.