Organization · Type 2 NPI

Walgreen Louisiana Co Inc

Pharmacy · Lake Charles, LA

NPI number 1629084017 Active

Practice location

2636 Ryan St
Lake Charles, LA 70601-7326

Call (337) 433-4178 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	1166RC (LA)
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

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NPI record

NPI: 1629084017
Entity type: Organization (Type 2)
Issued: Jul 31, 2006
Last updated: Feb 10, 2026
Status: Active
Subpart: Yes of Walgreens Boots Alliance Inc

Other names

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Walgreens #06219 · doing business as
Walgreens #06219 · 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 1629084017

Walgreen Louisiana Co Inc's National Provider Identifier is 1629084017, issued on Jul 31, 2006. The primary taxonomy on file is Pharmacy (333600000X), and the practice location is in Lake Charles, LA. The record was last updated on Feb 10, 2026.