Organization · Type 2 NPI

Walgreen Co

Pharmacy · Walla Walla, WA

NPI number 1407949068 Active

Practice location

633 W Tietan St
Walla Walla, WA 99362-4329

Call (509) 529-1570 Map

Fax (509) 529-5283

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	CF58766 (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…

7 other providers at this address

Other pharmacy providers in Walla Walla

Providence Health & Services - WashingtonPharmacy Walla Walla, WA NPI 1780828327

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NPI record

NPI: 1407949068
Entity type: Organization (Type 2)
Issued: Oct 2, 2006
Last updated: Aug 26, 2026
Status: Active
Subpart: Yes of Walgreen Co

Other names

<unavail>
Walgreens #10107 · doing business as
Walgreens #10107 · 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 1407949068

Walgreen Co's National Provider Identifier is 1407949068, issued on Oct 2, 2006. The primary taxonomy on file is Pharmacy (333600000X), and the practice location is in Walla Walla, WA. The record was last updated on Aug 26, 2026.