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Export Provider Record NPI 1063905552
Walgreen Co
Organization Subpart: YES
Active
NPI Number1063905552
NPI TypeNPI-2 Organization
SpecialtyPharmacy
Provider Details
NPI1063905552
NPI TypeNPI-2 Organization
StatusActive
Enumeration Date2018-06-11
Last Updated2024-12-05
Authorized OfficialJennifer Ponce
Manager
Phone: 8475272489
Mailing Address1901 E Voorhees St, Ms 790
Danville, IL 61834-4509
United States
Phone: (847) 527-2489 | Fax: (217) 709-2344
📍 View Map
Primary Practice Address200 Rutledge Ave
Charleston, SC 29403-5848
United States
Phone: (843) 779-3690 | Fax: (843) 779-3691
📍 View Map
Other Identifiers
IssuerStateNumberOther Issuer
Other (non-Medicare)SC4235710NCPDP
Taxonomy / Specialty
PrimaryTaxonomy Code & DescriptionStateLicense Number
No332B00000X – Durable Medical Equipment & Medical Supplies
Yes333600000X – Pharmacy
No3336C0003X – Pharmacy, Community/Retail Pharmacy
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About NPI 1063905552

Walgreen Co is an organization registered in the CMS NPPES NPI Registry with NPI number 1063905552. The primary specialty listed is Pharmacy. The organization is located in Charleston, SC. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2018-06-11. All data is sourced directly from the official CMS NPPES public API and is updated daily.

Frequently Asked Questions

What is NPI 1063905552?

NPI 1063905552 belongs to Walgreen Co, a Pharmacy in Charleston, SC. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.

Is NPI 1063905552 active?

The current status of NPI 1063905552 in the NPPES registry is Active. The record was last updated on 2024-12-05.

What specialty is NPI 1063905552?

NPI 1063905552 is classified under the taxonomy Pharmacy. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.

How do I verify NPI 1063905552?

You can verify NPI 1063905552 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.

What address is on file for NPI 1063905552?

The primary practice address on file for NPI 1063905552 is 200 Rutledge Ave, Charleston, SC 29403-5848. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.

When was NPI 1063905552 issued?

NPI 1063905552 was first issued (enumerated) on 2018-06-11. The NPPES record was last updated on 2024-12-05.

Practice Location Map

Walgreen Co is located at 200 Rutledge Ave, Charleston, SC. Use the map below to find directions or verify the practice location.

📍 200 Rutledge Ave, Charleston, SC 29403-5848  ·  Open in Google Maps ↗

Related Healthcare Providers

The following providers share the same practice location, specialty, or state as Walgreen Co. All records sourced from the CMS NPPES registry.

Data Verified from CMS NPPES Last synced: 2026-06-18 · Source: npiregistry.cms.hhs.gov · 45 CFR Part 162