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Active NPI 1134134331 Organization (Entity Type 2) Subpart Facility

Walgreen Co

Pharmacy • St Augustine, FL

Parent Organization: Walgreens Boots Alliance Inc

About Walgreen Co NPI 1134134331 Summary

Walgreen Co is a verified healthcare organization specializing in Pharmacy operating in St Augustine, FL. Located at 2075 US HIGHWAY 1 S, this facility provides patient care and medical services under National Provider Identifier (NPI) 1134134331.

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 4 linked healthcare practitioners providing clinical services.

Facility Location & Contact Primary Location

Facility Address

2075 Us Highway 1 S

St Augustine, FL 320866000

Telephone 9048295240

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

4 Linked

Pharmacist

St Augustine, FL

View Practitioner Profile →

Pharmacist

St Augustine, FL

View Practitioner Profile →

Pharmacist

St Augustine, FL

View Practitioner Profile →

Facility & Registry History Timeline

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

10 Historical Events
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Updated Business Mailing Address January 10, 2026

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

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Medical Taxonomy / Specialty Registered (Primary Specialty) January 10, 2026

Pharmacy

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Medical Taxonomy / Specialty Registered (Primary Specialty) October 31, 2023

Durable Medical Equipment & Medical Supplies

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Medical Taxonomy / Specialty Registered (Primary Specialty) March 07, 2022

Pharmacy

NPI Profile Active October 01, 2015

NPI status registered as active in NPPES database

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Updated Practice Location October 01, 2015

Registered at 2075 US HIGHWAY 1 S, ST AUGUSTINE, FL 320866000 (Tel: 9048295358)

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Updated Business Mailing Address October 01, 2015

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

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Organization / Clinic Name Updated October 01, 2015

Operating as WALGREEN CO

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Medical Taxonomy / Specialty Registered (Primary Specialty) October 01, 2015

Durable Medical Equipment & Medical Supplies

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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: 1134134331
Entity Type:
Organization Organization (Hospital, Clinic, Group Practice) (Type 2 NPI)
Enumeration Date: July 29, 2006
Last Update: January 10, 2026

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.