Organization · Type 2 NPI

Walgreen Co

Pharmacy · San Ramon, CA

NPI number 1417403098 Active

Practice location

11440 Windemere Pkwy
San Ramon, CA 94582-5179

Call (925) 364-6401 Map

Fax (925) 364-6402

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	54660 (CA)
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…

5 other providers at this address

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NPI record

NPI: 1417403098
Entity type: Organization (Type 2)
Issued: Sep 1, 2016
Last updated: Jun 10, 2026
Status: Active
Subpart: Yes of Walgreens Holding Company

Other names

<unavail>
Walgreens #16090 · doing business as
Walgreens #16090 · doing business as

Authorized official

Jennifer Ponce
Manager
(847) 527-2489

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About NPI 1417403098

Walgreen Co's National Provider Identifier is 1417403098, issued on Sep 1, 2016. The primary taxonomy on file is Pharmacy (333600000X), and the practice location is in San Ramon, CA. The record was last updated on Jun 10, 2026.