Walgreen Co
NPI 1609030485ActiveOrganization· Pharmacy· Hazlehurst, MS
Pharmacy in Hazlehurst, Mississippi, registered in NPPES in July 2008, part of Walgreens Holding Company. The authorized official on file is Jennifer Ponce, Manager. Medicare paid $30,074 for services to 130 patients in 2024.
Overview
| NPI | 1609030485 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Walgreens Holding Company |
| NPI issued | Jul 11, 2008 |
| Last updated in NPPES | Oct 12, 2026 |
| Certified by provider | Oct 12, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pharmacy Primary | 333600000X | 07830/01.2 | MS |
| 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 (MS) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 130 |
|---|---|
| Services billed | 384 across 9 procedure codes |
| Paid by Medicare | $30,074 |
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