Walgreen Co
NPI 1104166479ActiveOrganization· Pharmacy· Eagle River, AK
Pharmacy in Eagle River, Alaska, registered in NPPES in February 2013, part of Walgreens Holding Company. The authorized official on file is Jennifer Ponce, Manager. Enrolled in Medicare as dme supplier - pharmacy and part b supplier - independent clinical laboratory.
Overview
| NPI | 1104166479 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Walgreens Holding Company |
| NPI issued | Feb 25, 2013 |
| Last updated in NPPES | Aug 27, 2026 |
| Certified by provider | Aug 27, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pharmacy Primary | 333600000X | 485 | AK |
| Durable Medical Equipment & Medical Supplies | 332B00000X | — | — |
| Pharmacy, Community/Retail Pharmacy | 3336C0003X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled DME Supplier - Pharmacy (AK); Part B Supplier - Independent Clinical Laboratory (AK) |
|---|