Walgreen Co
NPI 1477787562ActiveOrganization· Pharmacy· Lake Wylie, SC
Pharmacy in Lake Wylie, South Carolina, registered in NPPES in May 2009, part of Walgreens Holding Company. The authorized official on file is Jennifer Ponce, Manager. Medicare paid $50,171 for services to 206 patients in 2024.
Overview
| NPI | 1477787562 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Walgreens Holding Company |
| NPI issued | May 5, 2009 |
| Last updated in NPPES | Oct 14, 2026 |
| Certified by provider | Oct 14, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pharmacy Primary | 333600000X | 50-010455 | SC |
| 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 (SC) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 206 |
|---|---|
| Services billed | 650 across 8 procedure codes |
| Paid by Medicare | $50,171 |