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Active NPI 1003821141 Organization (Entity Type 2) Subpart Facility

Walgreen Co

Pharmacy • Cocoa Beach, FL

Parent Organization: Walgreens Boots Alliance Inc

Public Directory Information & Medical Disclaimer

This facility profile is compiled from official public domain records provided by CMS and the NPPES registry. TRUE-MEDINFO is an independent reference directory and does not provide medical advice, diagnosis, or healthcare referrals. Always consult a qualified medical professional for health queries.

About Walgreen Co NPI 1003821141 Summary

Walgreen Co is a verified healthcare organization specializing in Pharmacy operating in Cocoa Beach, FL. Located at 4150 N ATLANTIC AVE, this facility provides patient care and medical services under National Provider Identifier (NPI) 1003821141.

Walgreen Co operates as a subpart facility of Walgreens Boots Alliance Inc. Administrative operations and authorized compliance are overseen by Jennifer Ponce (Manager).

The facility is associated with 10 linked healthcare practitioners providing clinical services.

Facility Location & Contact Primary Location

Facility Address

4150 N Atlantic Ave

Cocoa Beach, FL 329313510

Telephone 3217999112

Authorized Official Information

Authorized Contact Name

Jennifer Ponce

Title / Role

Manager

Official Telephone

8475272489

Facility Classifications & Specialties

Pharmacy Primary Taxonomy

NUCC Taxonomy Code: 333600000X

A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

Durable Medical Equipment & Medical Supplies

NUCC Taxonomy Code: 332B00000X

A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.

Pharmacy - Community/Retail Pharmacy

NUCC Taxonomy Code: 3336C0003X

A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

Affiliated Practitioners & Clinicians

Healthcare professionals and specialists practicing at this facility or affiliated group locations

10 Linked
Anh Phan NPI 1033798590

Pharmacist

Cocoa Beach, FL

View Practitioner Profile →
Brandy Labarge NPI 1174358840

Pharmacist

Cocoa Beach, FL

View Practitioner Profile →
Miriam Ruffolo , RPH NPI 1205117256

Pharmacist

Cocoa Beach, FL

View Practitioner Profile →

Pharmacist

Cocoa Beach, FL

View Practitioner Profile →

Pharmacist

Cocoa Beach, FL

View Practitioner Profile →
Raikeshia Moultrie NPI 1326741737

Pharmacist

Cocoa Beach, FL

View Practitioner Profile →

Facility & Registry History Timeline

Chronological log of verified NPI organization updates, branch relocations, and registry updates

13 Historical Events
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Updated Business Mailing Address August 01, 2025

Registered at 1901 E VOORHEES ST # MS 790, DANVILLE, IL 618344515 (Tel: 8475272489)

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Medical Taxonomy / Specialty Registered (Primary Specialty) August 01, 2025

Pharmacy

NPI Profile Active April 03, 2017

NPI status registered as active in NPPES database

📍
Updated Practice Location April 03, 2017

Registered at 4150 N ATLANTIC AVE, COCOA BEACH, FL 329313510 (Tel: 3217999110)

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Updated Business Mailing Address April 03, 2017

Registered at 1901 E VOORHEES ST, MS #790, DANVILLE, IL 618344509 (Tel: 2177092386)

🏛️
Organization / Clinic Name Updated April 03, 2017

Operating as WALGREEN CO

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Medical Taxonomy / Specialty Registered (Primary Specialty) April 03, 2017

Durable Medical Equipment & Medical Supplies

NPI Profile Active August 31, 2015

NPI status registered as active in NPPES database

📍
Updated Practice Location August 31, 2015

Registered at 4150 N ATLANTIC AVE, COCOA BEACH, FL 329313510 (Tel: 3217999110)

📍
Updated Business Mailing Address August 31, 2015

Registered at 1901 E VOORHEES ST, MS #790, DANVILLE, IL 618344509 (Tel: 2175548964)

🏛️
Organization / Clinic Name Updated August 31, 2015

Operating as WALGREEN CO

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 31, 2015

Durable Medical Equipment & Medical Supplies

🟢
Initial NPI Registration & Enumeration July 29, 2006

First registered as active Healthcare Organization in NPPES Database.

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NPI Organization Metadata

NPI Number: 1003821141
Entity Type:
Organization Organization (Hospital, Clinic, Group Practice) (Type 2 NPI)
Enumeration Date: July 29, 2006
Last Update: August 01, 2025

Mailing Address

1901 E Voorhees St # Ms 790

Danville, IL 618344515

Phone: 8475272489

Public Domain Record This organization profile is sourced from public domain datasets published by CMS and NPPES under FOIA.
⚠️ Medical Disclaimer

Facility details are provided for public information only. In case of a medical emergency, call 911 immediately.