Walgreen Co
NPI 1558636555ActiveOrganization· Pharmacy· Champaign, IL
Pharmacy in Champaign, Illinois, registered in NPPES in March 2012, part of Walgreens Holding Company. The authorized official on file is Jennifer Ponce, Manager. Medicare paid $3,486 for services to 17 patients in 2024.
Overview
| NPI | 1558636555 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Walgreens Holding Company |
| NPI issued | Mar 9, 2012 |
| Last updated in NPPES | Sep 23, 2026 |
| Certified by provider | Sep 23, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pharmacy Primary | 333600000X | — | — |
| 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 (IL) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 17 |
|---|---|
| Services billed | 44 across 5 procedure codes |
| Paid by Medicare | $3,486 |
Other Pharmacy providers in Champaign
- 1578618914
- 1871648600
- 1285675157
- 1861414674
- 1346674280
- 1134139090
- 1225320260
- 1235404245
- 1316331630
- 1568754695
- 1669487773
- 1689689705