Walgreen Co
NPI 1962415091ActiveOrganization· Pharmacy· Moorhead, MN
Pharmacy in Moorhead, Minnesota, registered in NPPES in August 2006, part of Walgreens Holding Company. The authorized official on file is Jennifer Ponce, Manager. Medicare paid $44,651 for services to 164 patients in 2024.
Overview
| NPI | 1962415091 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Walgreens Holding Company |
| NPI issued | Aug 13, 2006 |
| Last updated in NPPES | Oct 19, 2026 |
| Certified by provider | Oct 19, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pharmacy Primary | 333600000X | 260147 | MN |
| 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 (MN) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 164 |
|---|---|
| Services billed | 568 across 12 procedure codes |
| Paid by Medicare | $44,651 |
Other Pharmacy providers in Moorhead
- 1043232721
- 1780287300
- 1235469826