Organization · Type 2 NPI

Walgreen Co

Pharmacy · Bridgeport, CT

NPI number 1467986455 Active

Practice location

300 Fairfield Ave Ste 103
Bridgeport, CT 06604-4316

Call (203) 923-0054 Map

Fax (203) 923-0055

Mailing address

1901 E Voorhees St, Ms 790
Danville, IL 61834-4509

Specialties and licenses

Taxonomy	Code	License
Durable Medical Equipment & Medical Supplies	332B00000X	None listed
Pharmacy Primary	333600000X	None listed
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…

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NPI record

NPI: 1467986455
Entity type: Organization (Type 2)
Issued: Apr 17, 2017
Last updated: Oct 13, 2026
Status: Active
Subpart: Yes of Walgreens Holding Company

Other names

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Walgreens Specialty Pharmacy #16548 · 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.

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About NPI 1467986455

Walgreen Co's National Provider Identifier is 1467986455, issued on Apr 17, 2017. The primary taxonomy on file is Pharmacy (333600000X), and the practice location is in Bridgeport, CT. The record was last updated on Oct 13, 2026.