Walgreen Co
Walgreen Co is a healthcare organization registered as Pharmacy in Red Oak, TX, holding Type 2 (organization) NPI 1063763134 since 2012. The authorized official on file is Jennifer Ponce, Manager.
✓ Active NPI ✓ Valid NPI checksum Organization subpart
| NPI | 1063763134 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Walgreen Co |
| Other name | <Unavail> |
| Parent organization | Walgreens Boots Alliance Inc |
| Practice address | 107 E OVILLA RD, Red Oak, TX, 75154 |
| Phone | 9725763303 |
| Fax | 9725763716 |
| Enumeration date | 2012-09-28 |
| Last updated in NPPES | 2024-10-09 |
Authorized official
| Name | Jennifer Ponce |
|---|---|
| Title | Manager |
| Phone | 8475272489 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 3336C0003X | Community/Retail Pharmacy | Secondary | — | — |
| 291U00000X | Clinical Medical Laboratory | Secondary | — | — |
| 332B00000X | Durable Medical Equipment & Medical Supplies | Secondary | — | — |
| 333600000X | Pharmacy | Primary | 28274 | TX |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 466857 | Medicaid | TX | — |
| 468336 | Medicaid | TX | — |
| 5907122 | Other | TX | NCPDP |
Copy-ready billing details
Provider: Walgreen Co NPI: 1063763134 Taxonomy: 333600000X (Pharmacy) Address: 107 E OVILLA RD, Red Oak, TX, 75154
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1285246736 | Yonas Kolaso | Individual | Pharmacist | Red Oak, TX |
| 1295339505 | Shane Malekouti | Individual | Pharmacist | Red Oak, TX |
Verify this record
Cross-check NPI 1063763134 against the authoritative CMS record: view Walgreen Co on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
Where is Walgreen Co located?
How current is this record?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2024-10-09.