{"npi":"1790790772","type":"NPI-2","status":"active","name":{"display":"Walgreen Co","other":[],"organization_name":"WALGREEN CO","authorised_official":"Jennifer Ponce"},"specialty":{"primary_taxonomy":"333600000X","primary_taxonomy_description":"Pharmacy","slug":"pharmacy","schema_org_specialty":null,"all":[{"code":"3336C0003X","description":"Community/Retail Pharmacy","primary":false,"state":null,"license":null},{"code":"332B00000X","description":"Durable Medical Equipment & Medical Supplies","primary":false,"state":null,"license":null},{"code":"333600000X","description":"Pharmacy","primary":true,"state":"OK","license":"28-4735"}]},"addresses":[{"purpose":"LOCATION","street_1":"1019 E MAIN ST","city":"WEATHERFORD","state":"OK","postal_code":"730965743","country_code":"US","phone":"5807722956"},{"purpose":"MAILING","street_1":"1901 E VOORHEES ST","city":"DANVILLE","state":"IL","postal_code":"618344515","country_code":"US","street_2":"MS 790","phone":"8475272489","fax":"2177092344"}],"license":{"state":"OK","number":"28-4735"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"100234240P","state":"OK","issuer":null},{"type_code":"01","label":"Other","value":"3723776","state":null,"issuer":"OTHER ID NUMBER-COMMERCIAL NUMBER"},{"type_code":"05","label":"Medicaid","value":"100234240Q DME","state":"OK","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"O20100930056912","type_code":"30-A5","type_desc":"DME SUPPLIER - PHARMACY","state":"OK","pac_id":"0941278253"}]},"enumeration_date":"2006-07-29","last_updated":"2025-11-24","_meta":{"source":"NPPES","snapshot_date":"2025-11-24","doc_url":"https://findmynpi.com/api"}}