Walgreen Co
NPI 1124210166ActiveOrganization· Pharmacy· Beaver Dam, WI
Pharmacy in Beaver Dam, Wisconsin, registered in NPPES in August 2007, part of Walgreens Boots Alliance Inc. The authorized official on file is Jennifer Ponce, Manager. Medicare paid $218,220 for services to 797 patients in 2024.
Overview
| NPI | 1124210166 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Walgreens Boots Alliance Inc |
| NPI issued | Aug 14, 2007 |
| Last updated in NPPES | Jan 12, 2026 |
| Certified by provider | Jan 12, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pharmacy Primary | 333600000X | 8776-042 | WI |
| 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 (WI) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 797 |
|---|---|
| Services billed | 2,774 across 12 procedure codes |
| Paid by Medicare | $218,220 |
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