Walgreen Co
NPI 1770838518ActiveOrganization· Pharmacy· Russellville, AR
Pharmacy in Russellville, Arkansas, registered in NPPES in July 2012, part of Walgreens Holding Company. The authorized official on file is Jennifer Ponce, Manager. Enrolled in Medicare as dme supplier - pharmacy.
Overview
| NPI | 1770838518 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Walgreens Holding Company |
| NPI issued | Jul 18, 2012 |
| Last updated in NPPES | Oct 12, 2026 |
| Certified by provider | Oct 12, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pharmacy Primary | 333600000X | AR20680 | AR |
| 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 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled DME Supplier - Pharmacy (AR) |
|---|
Other Pharmacy providers in Russellville
- 1134617301
- 1609980028
- 1164449591