NPI age
19 years
Enumerated 2006-07-29
● Active Type 2 · Organization
Subpart
Walgreen Co
Walgreen Co is 1 of 961 pharmacy organizations in Georgia.
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
2024-10-08
Source: monthly bulk 2026-05
How this organization compares
Across 961 active pharmacy providers in Georgia.
NPI age
19 years
≈ at median (18 yr)
Practice locations
1
0 secondary on file
Subspecialties
2
In the 80% of peers with subspecialties
NPI lifetime · 2006 → 2026
2006-07Enumerated in NPPES
2006
2026
Where they practice
Primary practice location
3414 Mundy Mill Rd
Gainesville, GA 305078215
Mailing address
1901 E Voorhees St, MS 790
Danville, IL 618344509
Authorized official
Jennifer Ponce
Manager
📞 8475272489
Individual providers at this organization
3 individual providers on file at this primary practice address.
- Kofi Bawuah, RPH Pharmacist NPI 1316220064
- Toan Hoang, PHARMD Pharmacist NPI 1326558099
- Paul Tillman Pharmacist NPI 1447536859
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 |
|---|---|---|
| 01 | 1153155 | OTHER ID NUMBER-COMMERCIAL NUMBER |
| 05 (GA) | 672137484A |
Other names on file (2)
Doing-business-as, former, and alternate names recorded by NPPES.
-
WALGREENS #09155
-
WALGREENS #09155
Practice context
Multi-provider organization. 3 individual providers on file at this primary address.
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.