Organization · Type 2 NPI

Walgreen Co

Pharmacy · Lexington, KY

NPI number 1477055499 Active

Practice location

393 Waller Ave Ste 5
Lexington, KY 40504-2914

Call (859) 551-4447 Map

Fax (859) 551-4448

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	P07998 (KY)
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: 1477055499
Entity type: Organization (Type 2)
Issued: Mar 6, 2018
Last updated: Jun 12, 2026
Status: Active
Subpart: Yes of Walgreens Holding Company

Other names

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Walgreens Specialty Pharmacy #21170 · 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 1477055499

Walgreen Co's National Provider Identifier is 1477055499, issued on Mar 6, 2018. The primary taxonomy on file is Pharmacy (333600000X), and the practice location is in Lexington, KY. The record was last updated on Jun 12, 2026.