Organization · Type 2 NPI

Walgreen Co

Pharmacy · St. Louis, MO

NPI number 1396018883 Active

Practice location

115 N Euclid Ave Ste A
St. Louis, MO 63108-1503

Call (314) 454-6676 Map

Fax (314) 367-1881

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	2012013999 (MO)
Community/Retail Pharmacy	3336C0003X	None listed
Compounding Pharmacy	3336C0004X	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 St. Louis

See all in St. Louis →

NPI record

NPI: 1396018883
Entity type: Organization (Type 2)
Issued: Feb 15, 2012
Last updated: Oct 21, 2025
Status: Active
Subpart: Yes of Walgreens Boots Alliance Inc

Other names

<unavail>
Walgreens Specialty Pharmacy #15311 · 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 1396018883

Walgreen Co's National Provider Identifier is 1396018883, issued on Feb 15, 2012. The primary taxonomy on file is Pharmacy (333600000X), and the practice location is in St. Louis, MO. The record was last updated on Oct 21, 2025.