Walgreen Co
NPI 1629297734ActiveOrganization· Pharmacy· Fortuna, CA
Pharmacy in Fortuna, California, registered in NPPES in April 2007, part of Walgreens Holding Company. The authorized official on file is Jennifer Ponce, Manager. Medicare paid $94,774 for services to 350 patients in 2024.
Overview
| NPI | 1629297734 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Walgreens Holding Company |
| NPI issued | Apr 25, 2007 |
| Last updated in NPPES | Jun 9, 2026 |
| Certified by provider | Jun 9, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pharmacy Primary | 333600000X | PHY48602 | CA |
| 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 (CA) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 350 |
|---|---|
| Services billed | 1,184 across 12 procedure codes |
| Paid by Medicare | $94,774 |
Other pharmacies in Fortuna
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