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WALGREEN CO
NPI 1063883403
Pharmacy in Detroit, MI

Active since October 12, 2015
4501 WOODWARD AVE, SUITE 105, DETROIT, MI 48201(313) 230-2170(312) 230-2004 Get Directions Write a Review

NPPES record last updated: June 3, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jun 3, 2026, Jun 25, 2025, May 6, 2022 and 4 more (7 updates tracked since 2015).

About Walgreen Co NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WALGREEN CO (NPI 1063883403), doing business as Walgreens Specialty Pharmacy #16374, is a healthcare organization registered as a pharmacy in Detroit, Michigan and active in the NPI registry since October 2015. The organization lists Jennifer Ponce, Manager, as its authorized official.

NPPES Registry Identity

NPI1063883403
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NameWALGREEN CO
Location Address4501 WOODWARD AVE, SUITE 105Detroit, MI 48201-1890
Mailing Address1901 E Voorhees St # Ms 790Danville, IL 61834-4515 · (847) 527-2489 · Fax (217) 709-2344
Phone(313) 230-2170
Fax(312) 230-2004
Organization SubpartYesParent: Walgreens Holding Company
Authorized OfficialJennifer PonceManager · (847) 527-2489
Enumeration DateOctober 12, 2015
Last NPPES UpdateJune 3, 20267 updates tracked since enumeration
NPPES CertifiedJune 3, 2026
✔ NPI 1063883403 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacySuppliers
Taxonomy Code333600000X
License✔ Licensed in MI · 5301010747
Definition
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.
Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X
Also ListedPharmacy · Community/Retail PharmacyTaxonomy 3336C0003X
4501 WOODWARD AVE, Detroit, MI 48201
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Other Names 1

Doing Business AsWalgreens Specialty Pharmacy #16374

Other Identifiers 2

Medicaid1063883403MI
Other2381262MI · Ncpdp

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arkansas Health & Wellness and more.Insurance ›

Medical Equipment Supplier Medicare DMEPOS 7

Medicare supplier enrollment and the product categories Walgreens #16374 carries, from the Medicare DMEPOS supplier directory.

Walgreens #16374

DMEPOS supplier · Detroit, MIOperated by Walgreen Co
✔

Accepts Medicare assignment

Walgreens #16374 agrees to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients are not billed beyond the standard deductible and coinsurance.

PTAN (Medicare Supplier Number)20395721
Medicare Participant SinceMarch 1, 2022
Supplier Location4501 Woodward Ave Ste 105Detroit, MI 48201
Phone(313) 230-2170
Supplier Specialties
Pharmacy

Medicare Product Categories

Epoetin
Epoetin is a man-made version of human erythropoietin (EPO)
Immunosuppressive Drugs
Immunosuppressive drugs require dosage, frequency, and route of administration to prevent or treat the rejection of an organ transplant
Infusion Drugs
Nebulizer Drugs
Albuterol, levalbuterol, and metaproterenol are all short-acting bronchodilators with beta-adrenergic stimulatory effect
Oral Anticancer Drugs
FDA anticancer drugs
Oral Antiemetic Drugs
FDA antiemetic drugs
Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KNIGHT PRESCRIPTION SERVICES
Pharmacy
4501 WOODWARD AVE, SUITE 104A
DETROIT, MI 48201
Wayne County (313) 832-5800
WOODWARD RX LLC
Pharmacy (Community/Retail Pharmacy)
4501 WOODWARD AVE
DETROIT, MI 48201
Wayne County (313) 832-5800

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Walgreen Co's NPI number?

The NPI number for Walgreen Co is 1063883403. It was assigned to this organization in the NPPES registry on October 12, 2015. The provider is doing business as Walgreens Specialty Pharmacy #16374.

Where is Walgreen Co located?

Walgreen Co is located at 4501 Woodward Ave Suite 105, Detroit, MI 48201. The listed phone number is (313) 230-2170.

What is Walgreen Co's specialty?

The primary specialty registered for this NPI is Pharmacy with taxonomy code 333600000X.

Does Walgreen Co accept Medicare assignment for medical equipment?

Yes. As a Medicare medical equipment supplier, Walgreens #16374 accepts Medicare assignment: the supplier accepts the Medicare-approved amount as payment in full for covered equipment and supplies.

What insurance does Walgreen Co accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter Health of Delaware, Ambetter from Absolute Total Care and Ambetter from Arkansas Health & Wellness and 41 other insurers list Walgreen Co as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Walgreen Co was last updated on June 3, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.