Walgreen Co
Walgreen Co is a healthcare organization registered as Pharmacy in Tifton, GA, holding Type 2 (organization) NPI 1205016771 since 2007. The authorized official on file is Jennifer Ponce, Manager.
✓ Active NPI ✓ Valid NPI checksum Organization subpart
| NPI | 1205016771 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Walgreen Co |
| Other name | <Unavail> |
| Parent organization | Walgreens Boots Alliance Inc |
| Practice address | 615 LOVE AVE, Tifton, GA, 31794 |
| Phone | 2293825359 |
| Fax | 2293825231 |
| Enumeration date | 2007-11-13 |
| Last updated in NPPES | 2025-08-06 |
Authorized official
| Name | Jennifer Ponce |
|---|---|
| Title | Manager |
| Phone | 8475272489 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 332B00000X | Durable Medical Equipment & Medical Supplies | Secondary | — | — |
| 3336C0003X | Community/Retail Pharmacy | Secondary | — | — |
| 333600000X | Pharmacy | Primary | PHRE009426 | GA |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 085235405B DME | Medicaid | GA | — |
| 1156555 | Other | — | NCPDP |
| 085235405A | Medicaid | GA | — |
Copy-ready billing details
Provider: Walgreen Co NPI: 1205016771 Taxonomy: 333600000X (Pharmacy) Address: 615 LOVE AVE, Tifton, GA, 31794
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1538441142 | Willis Holland | Individual | Pharmacist | Tifton, GA |
| 1659641140 | Yi Huang | Individual | Pharmacist | Tifton, GA |
| 1386905347 | John Ewing | Individual | Pharmacist | Tifton, GA |
| 1578219333 | Yongmin Jerzak | Individual | Pharmacist | Tifton, GA |
Verify this record
Cross-check NPI 1205016771 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
Who is the authorized official for Walgreen Co?
What is the NPI number for Walgreen Co?
Source: CMS NPPES (public data). Snapshot 2026-07-10. Provider record last updated 2025-08-06.