WALGREEN EASTERN CO INC NPI 1174538151

NPI Information

  • NPI: 1174538151
  • Provider Name: WALGREEN EASTERN CO, INC
  • Classification: Pharmacy - 333600000X
  • Entity Type: Organization
  • :
  • CLIA Number: 31D2036274
  • Address: 383 WASHINGTON AVE
    HILLSDALE, NJ
    ZIP 07642
  • Phone: (201) 664-4250

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NPI Details

WALGREEN EASTERN CO, INC is a pharmacy in Hillsdale, NJ. The provider is a facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. WALGREEN EASTERN CO, INC NPI is 1174538151. The provider is registered as an organization entity type.
The provider .

The provider's business location address is:

383 WASHINGTON AVE
HILLSDALE, NJ
ZIP 07642
Phone: (201) 664-4250
Fax: (201) 664-7647

The provider's authorized official is Jennifer Ponce .
The authorized official title is Manager and has the following contact phone number (847) 527-2489.

The CLIA number assigned to this NPI record is 31D2036274 - pharmacy with a certificate type of Certificate of Waiver.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count (HCPCS:K1034)
  • Administration of influenza virus vaccine (HCPCS:G0008)
  • Fee covid-19 vac 14 res (HCPCS:0134A)
  • Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage (HCPCS:90694)
  • Adm sarscov2 50mcg/0.25mlbst (HCPCS:0064A)
  • Influenza vaccine split virus, preservative free (HCPCS:90662)
  • Administration of pneumococcal vaccine (HCPCS:G0009)
  • Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use (HCPCS:90677)

The enumeration date for this NPI number is 7/29/2006 and was last updated on 6/16/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1332B00000XDurable Medical Equipment & Medical SuppliesNo
23336C0003XPharmacyCommunity/Retail PharmacyNo
3333600000XPharmacyRS003825NEW JERSEYYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
14375301MEDICAIDNEW JERSEY
23127796OTHERNEW JERSEYNCPDP

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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