Organization
WALGREEN EASTERN CO INC
Active
Parent organization
WALGREENS BOOTS ALLIANCE INC
Other names
Walgreens Specialty Pharmacy #15307
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
21 STANHOPE ST, #23, BOSTON, MA 02116-5111
(617) 375-7969
(617) 375-9656
Mailing address
1901 E VOORHEES ST, DANVILLE, IL 61834-4515
(847) 527-2489
(217) 709-2344
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
DS89805
MA
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003128718
—
CT
05
—
03481069
—
NY
05
—
110000108K
—
MA
01
—
2243791
NCPDP
MA
Enumeration date
02/14/2012
Last updated
01/14/2026
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