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NPI 1629083829

NPI 1629083829 : WALGREEN EASTERN CO INC : WESTFORD, MA

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General NPI Number Information
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    NPI Number           |    1629083829
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    Entity Type          |    Organization 
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    Legal Business Name  |    WALGREEN EASTERN CO INC 
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Dates
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    Enumeration Date     |    07/29/2006
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    Last Update Date     |    01/05/2026
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Provider Practice Location Address
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    Address Line         |    145 LITTLETON RD 
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    City                 |    WESTFORD
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    State                |    MA
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    Zip                  |    01886-3121
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    Country              |    US
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    Telephone            |    978-692-3075
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    Fax                  |    978-692-3126
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Provider Business Mailing Address
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    Address Line         |    1901 E VOORHEES ST MS 790
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    City                 |    DANVILLE
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    State                |    IL
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    Zip                  |    61834-4515
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    Country              |    US
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    Telephone            |    847-527-2489
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    Fax                  |    217-709-2344
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Authorized Official
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    Title or Position    |    MANAGER
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    Name                 |     JENNIFER  PONCE 
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    Credential           |    
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    Telephone            |    847-527-2489
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    3336C0003X
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    Taxonomy Name        |    Community/Retail Pharmacy
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    332B00000X
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    Taxonomy Name        |    Durable Medical Equipment & Medical Supplies
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    License Number       |    
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    License Number State |    
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Taxonomy #3
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    Taxonomy Code        |    333600000X
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    Taxonomy Name        |    Pharmacy
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    License Number       |    3497
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    License Number State |    MA
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