NPI 1134463359 · live from the CMS NPI Registry
Walgreen Co
Pharmacy in Laramie, WY. National Provider Identifier 1134463359, active.
NPI record
| NPI | 1134463359 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Pharmacy 333600000X |
| Practice location | 4005 E Grand Ave, Laramie, WY 82070 |
| Practice phone | 307-745-1557 |
| Mailing address | 1901 E Voorhees St, Ms 790, Danville, IL 61834 |
| Enumerated | November 15, 2012 |
| Last updated | August 27, 2026 |
| Authorized official | Jennifer Ponce, Manager |
| Other names | Walgreens #15606 |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | — |
| Pharmacy primary | 333600000X | R10091 (WY) |
| Pharmacy, Community/Retail Pharmacy | 3336C0003X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.