Organization · Type 2 NPI

Walgreen Co

Pharmacy · Grand Rapids, MI

NPI number 1710992011 Active

Practice location

2643 Kalamazoo Ave SE
Grand Rapids, MI 49507-3900

Call (616) 452-4870 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	5301008182 (MI)
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: 1710992011
Entity type: Organization (Type 2)
Issued: Jul 29, 2006
Last updated: Jun 3, 2026
Status: Active
Subpart: Yes of Walgreens Holding Company

Other names

<unavail>
Walgreens #09131 · doing business as
Walgreens #09131 · 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 1710992011

Walgreen Co's National Provider Identifier is 1710992011, issued on Jul 29, 2006. The primary taxonomy on file is Pharmacy (333600000X), and the practice location is in Grand Rapids, MI. The record was last updated on Jun 3, 2026.