Organization
WALGREEN EASTERN CO INC
Active
Parent organization
WALGREENS HOLDING COMPANY
Other names
Walgreens #17990
Organization subpart
Yes
Provider details
NPI number
Legal business name
WALGREENS HOLDING COMPANY
Authorized official
JENNIFER PONCE (MANAGER)
(847) 527-2489
Entity
Organization
Contact information
Practice address
943 WESTERN AVE, MANCHESTER, ME 04351
(207) 622-6598
(207) 623-3714
Mailing address
1901 E VOORHEES ST, DANVILLE, IL 61834-4515
(217) 709-2351
(217) 709-2344
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
—
—
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1588180038
—
ME
01
—
PH50001625
BOARD OF PHARMACY
ME
Enumeration date
08/16/2017
Last updated
08/06/2026
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