Organization · Type 2 NPI

Walgreen Co

Pharmacy · O Fallon, MO

NPI number 1619984622 Active

Practice location

920 N Main St
O Fallon, MO 63366-1746

Call (636) 379-2636 Map

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	2000172880 (MO)
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…

11 other providers at this address

Other pharmacy providers in O Fallon

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NPI record

NPI: 1619984622
Entity type: Organization (Type 2)
Issued: Aug 2, 2006
Last updated: Jun 24, 2025
Status: Active
Subpart: Yes of Walgreens Boots Alliance Inc

Other names

<unavail>
Walgreens #05552 · doing business as
Walgreens #05552 · 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 1619984622

Walgreen Co's National Provider Identifier is 1619984622, issued on Aug 2, 2006. The primary taxonomy on file is Pharmacy (333600000X), and the practice location is in O Fallon, MO. The record was last updated on Jun 24, 2025.