OrganizationActive
Walgreen Co
NPI 1205919610 · Pharmacy · Humboldt, TN
Provider details
- NPI number
- 1205919610
- Entity type
- Organization
- Primary specialty
- PharmacySuppliers
- Parent organization
- Walgreens Boots Alliance Inc
- Organization subpart
- Yes
- Authorized official
- Jennifer Ponce, Manager(847) 527-2489
- License
- 2132 (TN)
Specialties & taxonomies
Suppliers
Suppliers
- Community/Retail Pharmacy3336C0003X
Suppliers
Profile Score
Detailed profile(90/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
2401 N Central Ave
Humboldt, TN 38343-1753
Phone: (731) 784-2613
Fax: (731) 784-7410
Street-level locationGet directions
Mailing address
1901 E Voorhees St # Ms 790
Danville, IL 61834-4515
Other names (DBA / former)
- Doing business as
- Walgreens #15816
- Doing business as
- Walgreens #15816
Registry dates
- Enumerated
- 2006-10-23
- Last updated
- 2025-06-25
- Certified
- 2025-06-25
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.