Walgreen Co
NPI 1457693004ActiveOrganization· Pharmacy· Moultrie, GA
Pharmacy in Moultrie, Georgia, registered in NPPES in March 2013, part of Walgreens Holding Company. The authorized official on file is Jennifer Ponce, Manager. Enrolled in Medicare as dme supplier - pharmacy.
Overview
| NPI | 1457693004 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Walgreens Holding Company |
| NPI issued | Mar 21, 2013 |
| Last updated in NPPES | Oct 21, 2026 |
| Certified by provider | Oct 21, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pharmacy Primary | 333600000X | PHRE009932 | GA |
| 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 (GA) |
|---|
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