| NPI | 1083629331 |
|---|---|
| NPI Type | NPI-2 Organization |
| Status | Active |
| Enumeration Date | 2006-07-29 |
| Last Updated | 2025-08-05 |
| Authorized Official | Jennifer Ponce MANAGER Phone: 8475272489 |
| Mailing Address | 1901 E Voorhees St, Ms 790 Danville, IL 61834-4515 United States Phone: (847) 527-2489 | Fax: (217) 709-2344 📍 View Map |
| Primary Practice Address | 6951 S Kings Ranch Rd Gold Canyon, AZ 85118-3012 United States Phone: (480) 288-7208 📍 View Map |
| Issuer | State | Number | Other Issuer |
|---|---|---|---|
| Other (non-Medicare) | — | 0325882 | Other ID Number-Commercial Number |
| MEDICAID | AZ | 564337 | — |
| Primary | Taxonomy Code & Description | State | License Number |
|---|---|---|---|
| No | 332B00000X – Durable Medical Equipment & Medical Supplies | — | — |
| No | 3336C0003X – Pharmacy, Community/Retail Pharmacy | — | — |
| Yes | 333600000X – Pharmacy | AZ | Y03364 |
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About NPI 1083629331
Walgreen Co is an organization registered in the CMS NPPES NPI Registry with NPI number 1083629331. The primary specialty listed is Pharmacy. The organization is located in Gold Canyon, AZ. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2006-07-29. All data is sourced directly from the official CMS NPPES public API and is updated daily.
Frequently Asked Questions
What is NPI 1083629331?
NPI 1083629331 belongs to Walgreen Co, a Pharmacy in Gold Canyon, AZ. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.
Is NPI 1083629331 active?
The current status of NPI 1083629331 in the NPPES registry is Active. The record was last updated on 2025-08-05.
What specialty is NPI 1083629331?
NPI 1083629331 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 1083629331?
You can verify NPI 1083629331 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 1083629331?
The primary practice address on file for NPI 1083629331 is 6951 S Kings Ranch Rd, Gold Canyon, AZ 85118-3012. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.
When was NPI 1083629331 issued?
NPI 1083629331 was first issued (enumerated) on 2006-07-29. The NPPES record was last updated on 2025-08-05.
Practice Location Map
Walgreen Co is located at 6951 S Kings Ranch Rd, Gold Canyon, AZ. Use the map below to find directions or verify the practice location.
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.
License Information
The following state license numbers are on file in the NPPES registry for NPI 1083629331. For license status verification, contact the relevant state licensing board directly.
| Specialty / Taxonomy | License Number | State |
|---|---|---|
| Pharmacy | Y03364 | AZ |