Walgreen Co
NPI 1417131160ActiveOrganization· Pharmacy· Fulton, MO
Pharmacy in Fulton, Missouri, registered in NPPES in December 2007, part of Walgreens Holding Company. The authorized official on file is Jennifer Ponce, Manager. Medicare paid $49,728 for services to 192 patients in 2024.
Overview
| NPI | 1417131160 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Walgreens Holding Company |
| NPI issued | Dec 18, 2007 |
| Last updated in NPPES | Jul 22, 2026 |
| Certified by provider | Jul 22, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pharmacy Primary | 333600000X | 208019420 | MO |
| 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 (MO) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 192 |
|---|---|
| Services billed | 640 across 11 procedure codes |
| Paid by Medicare | $49,728 |
Other pharmacies in Fulton
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