Organization
WALGREEN EASTERN CO, INC
Active
Parent organization
WALGREENS BOOTS ALLIANCE INC
Other names
WALGREENS #04092
Organization subpart
Yes
Provider details
NPI number
Legal business name
WALGREENS BOOTS ALLIANCE INC
Authorized official
JENNIFER PONCE (MANAGER)
(847) 527-2489
Entity
Organization
Contact information
Practice address
593 MARKET ST, ELMWOOD PARK, NJ 07407
(201) 797-5839
Mailing address
1901 E VOORHEES ST, MS #790, DANVILLE, IL 61834-4515
(847) 527-2489
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
RS003822
NJ
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3127823
NCPDP
NJ
05
—
4375505
—
NJ
Enumeration date
08/02/2006
Last updated
10/01/2025
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