Organization
WALGREEN EASTERN CO, INC
Active
Parent organization
WALGREENS BOOTS ALLIANCE INC
Other names
WALGREENS #03192
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
649 W MAIN ST STE 2, WATERBURY, CT 06702-1082
(203) 757-6010
Mailing address
1901 E VOORHEES ST, MS 790, 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
1521
CT
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004138873 DME
—
CT
01
—
0715459
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
940004135811
—
CT
Enumeration date
07/29/2006
Last updated
01/02/2026
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