Walgreen Co
NPI 1063678209ActiveOrganization· Pharmacy· Fort Wayne, IN
Pharmacy in Fort Wayne, Indiana, registered in NPPES in August 2008, part of Walgreens Holding Company. The authorized official on file is Jennifer Ponce, Manager. Medicare paid $47,909 for services to 167 patients in 2024.
Overview
| NPI | 1063678209 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Walgreens Holding Company |
| NPI issued | Aug 6, 2008 |
| Last updated in NPPES | Oct 26, 2026 |
| Certified by provider | Oct 26, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pharmacy Primary | 333600000X | 60006171A | IN |
| Durable Medical Equipment & Medical Supplies | 332B00000X | — | — |
| Pharmacy, Community/Retail Pharmacy | 3336C0003X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled DME Supplier - Pharmacy (IN) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 167 |
|---|---|
| Services billed | 596 across 10 procedure codes |
| Paid by Medicare | $47,909 |
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