Walgreen Co
Walgreen Co is a healthcare organization registered as Pharmacy in Beaumont, CA, holding Type 2 (organization) NPI 1083629091 since 2006. The authorized official on file is Jennifer Ponce, Manager.
✓ Active NPI ✓ Valid NPI checksum Organization subpart
| NPI | 1083629091 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Walgreen Co |
| Other name | <Unavail> |
| Parent organization | Walgreens Boots Alliance Inc |
| Practice address | 1400 BEAUMONT AVE, Beaumont, CA, 92223 |
| Phone | 9517694295 |
| Enumeration date | 2006-07-29 |
| Last updated in NPPES | 2026-02-10 |
Authorized official
| Name | Jennifer Ponce |
|---|---|
| Title | Manager |
| Phone | 8475272489 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 3336C0003X | Community/Retail Pharmacy | Secondary | — | — |
| 332B00000X | Durable Medical Equipment & Medical Supplies | Secondary | — | — |
| 333600000X | Pharmacy | Primary | PHY46823 | CA |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083629091 | Medicaid | CA | — |
| PHA468230 | Medicaid | CA | — |
| 5613751 | Other | — | OTHER ID NUMBER-COMMERCIAL NUMBER |
Copy-ready billing details
Provider: Walgreen Co NPI: 1083629091 Taxonomy: 333600000X (Pharmacy) Address: 1400 BEAUMONT AVE, Beaumont, CA, 92223
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1508143058 | Jennifer Rivor | Individual | Pharmacist | Beaumont, CA |
| 1376813097 | Laura Perez-Munoz | Individual | Pharmacist | Beaumont, CA |
| 1275911869 | Robert Le | Individual | Pharmacist | Beaumont, CA |
| 1225578545 | Jeeyoon Kim | Individual | Pharmacist | Beaumont, CA |
| 1437931813 | Damidie Lare | Individual | Pharmacist | Beaumont, CA |
Verify this record
Cross-check NPI 1083629091 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
What type of organization is Walgreen Co?
What is a Type 2 NPI?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2026-02-10.