Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 30 days.

WALGREEN CO
NPI 1952596868
Pharmacy in Winston Salem, NC

Q: What is Walgreen Co's NPI number?

The NPI number for Walgreen Co is 1952596868. It was assigned to this organization in the NPPES registry on September 13, 2007. The provider is doing business as Walgreens #11202.

Q: What is Walgreen Co's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Walgreen Co was last updated on July 7, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since September 13, 2007CLIA 34D2011300 · Waiver

1712 S STRATFORD RD, WINSTON SALEM, NC 27103(336) 765-2967(336) 765-5378 Get Directions Write a Review

NPPES record last updated: July 7, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jul 7, 2026, Jul 26, 2024, Nov 6, 2023 and 1 more (4 updates tracked since 2015).

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About Walgreen Co NPPES

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

WALGREEN CO (NPI 1952596868), doing business as Walgreens #11202, is a healthcare organization registered as a pharmacy in Winston Salem, North Carolina and active in the NPI registry since September 2007. The organization holds a CLIA Waiver certificate valid through August 11, 2027 and lists Jennifer Ponce, Manager, as its authorized official.

NPPES Registry Identity

NPI1952596868

Entity TypeOrganization

Primary Taxonomy333600000X

Legal Business NameWALGREEN CO

Location Address1712 S STRATFORD RDWinston Salem, NC 27103-2926

Mailing Address1901 E Voorhees St, Ms 790Danville, IL 61834-4515 · (847) 527-2489 · Fax (217) 709-2344

Phone(336) 765-2967

Fax(336) 765-5378

Organization SubpartYesParent: Walgreens Holding Company

Authorized OfficialJennifer PonceManager · (847) 527-2489

Enumeration DateSeptember 13, 2007

Last NPPES UpdateJuly 7, 20264 updates tracked since enumeration

NPPES CertifiedJuly 7, 2026

✔ NPI 1952596868 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacySuppliers

Taxonomy Code333600000X

License✔ Licensed in NC · 09926

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

1712 S STRATFORD RD, Winston Salem, NC 27103

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Other Names 1

Doing Business AsWalgreens #11202

Other Identifiers 2

Other3409340Ncpdp

Medicaid0347372NC

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 ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 34D2011300

Walgreens #11202 · Winston-Salem, NC

Active · expires Aug 11, 2027

CLIA Number34D2011300

Laboratory TypePharmacy

Certificate Effective DateAugust 12, 2025

Certificate Expiration DateAugust 11, 2027

Laboratory DirectorLogan D. Davis

Laboratory Phone(336) 765-2967

Laboratory LocationWalgreens #112021712 South Stratford Road, Winston-Salem, NC 27103

CLIA data matches this NPI record on: Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

112 services112 patients

Influenza vaccine split virus, preservative free 90662

The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.

64 services64 patients

Influenza vaccine, inactivated 90653

The Influenza vaccine, inactivated, is a shot given to protect against the flu. It contains killed virus particles that help your body build immunity to the flu. It's recommended annually to keep your protection up-to-date. It's safe for ages 6 months and up.

43 services43 patients

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Other Providers at the Same Location NPPES 11

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

DR. THEODORA TSIARAS BALLAS PHARMD

Pharmacist