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Walgreen Co — NPI 1003002254, Gray, TN | NPI Central

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NPI 1003002254

OrganizationActive

Walgreen Co

NPI 1003002254 · Pharmacy · Gray, TN

Provider details

NPI number: 1003002254
Entity type: Organization
Primary specialty: PharmacySuppliers
Parent organization: Walgreens Boots Alliance Inc
Organization subpart: Yes
Authorized official: Jennifer Ponce, Manager(847) 527-2489

Specialties & taxonomies

PharmacyPrimary333600000XLicense 4444 (TN)
Suppliers
Durable Medical Equipment & Medical Supplies332B00000X
Suppliers
Community/Retail Pharmacy3336C0003X
Suppliers

Practice location

5104 Bobby Hicks Hwy

Gray, TN 37615-6217

Phone: (423) 477-3372

Fax: (423) 477-8533

Approximate (ZIP-level) locationGet directions

More TN providers

Mailing address

1901 E Voorhees St

Danville, IL 61834-4509

Other names (DBA / former)

Doing business as: Walgreens #11113
Doing business as: Walgreens #11113

Registry dates

Enumerated: 2007-09-21
Last updated: 2025-05-05
Certified: 2025-05-05

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.