NPI age
4 years
Enumerated 2021-10-21
● Active Type 2 · Organization
Subpart
Walgreen Co
Walgreen Co is 1 of 117 pharmacy organizations in Idaho.
Primary specialty
Pharmacy
Plus 2 secondary
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Ponce
Manager
Last NPPES update
2025-09-09
Source: monthly bulk 2026-05
How this organization compares
Across 117 active pharmacy providers in Idaho.
NPI age
4 years
↓ 13 yr below median
Practice locations
1
0 secondary on file
Subspecialties
2
In the 55% of peers with subspecialties
NPI lifetime · 2021 → 2026
2021-10Enumerated in NPPES
2021
2026
Where they practice
Primary practice location
1420 East 6th St
Weiser, ID 83672
Mailing address
1901 E Voorhees St, MS 790
Danville, IL 618344515
Authorized official
Jennifer Ponce
Manager
📞 8475272489
Specialties
-
Pharmacy PrimaryA 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...
-
Durable Medical Equipment & Medical SuppliesA 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.
-
PharmacyA 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...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 1245993740 | |
| 01 (ID) | 64452RP | BOARD OF PHARMACY |
Other names on file (2)
Doing-business-as, former, and alternate names recorded by NPPES.
-
Walgreens #21459
-
Walgreens #21459
Practice context
Single-site organization. Only one practice location on file.
Subpart of Walgreens Boots Alliance Inc.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Verify the organization is in good standing.Cross-check with the state's business registration and any applicable licensing boards.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.