Walgreen Eastern Co Inc

Primary specialty

PharmacyTaxonomy code 333600000X

License

19101 Issued in NY

Legal business name

WALGREEN EASTERN CO INC

Practice address

3355 Crescent St # 67
Long Island City, NY 11106-3809

Phone

(718) 932-8544

NPI assigned

Jul 29, 2006

Organization subpart

Yes

Parent organization

WALGREENS BOOTS ALLIANCE INCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kira Taylor

Title

Manager

Phone

(217) 709-2351

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Part of

Walgreens Holding Company

Member of 3

Organizations this organization is a member of, according to the National Provider Directory.

• Walgreen Co

  • Pharmacy
  • Phoenix, AZ
  • NPI 1356356695

  Member Of

  NPD member
• Walgreen Co

  • Pharmacy
  • Rio Rancho, NM
  • NPI 1528073426

  Member Of

  NPD member
• Walgreen Co

  • Pharmacy
  • Menomonie, WI
  • NPI 1962417048

  Member Of

  NPD member

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Walgreens Boots Alliance

  • Pharmacist
  • Syosset, NY
  • NPI 1346619889
  NPPES parent name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Betty Lu, PHARM D

  • Pharmacist
  • Long Island City, NY
  • NPI 1487962775
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698364800000",
    "number": "1023023108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 E VOORHEES ST",
            "address_2": "MS 790",
            "city": "DANVILLE",
            "state": "IL",
            "postal_code": "618344509",
            "telephone_number": "217-709-2351",
            "fax_number": "217-709-2344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3355 CRESCENT ST # 67",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111063809",
            "telephone_number": "718-932-8544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALGREEN EASTERN CO INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WALGREENS BOOTS ALLIANCE INC",
        "enumeration_date": "2006-07-29",
        "last_updated": "2023-10-27",
        "certification_date": "2023-10-27",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "KIRA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "217-709-2351"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NY",
            "license": "19101",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00967799",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "3386225",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mona Wakeley-Fishman, LCSW
• John Walden, LMSW
• Travain Yohance Waldron, RN
• Walgreen Co
• Walgreen Co
• Angelle Walker, RN
• Ebony Walker
• Kimberly A Walker
• Ranitra Elaine Walker
• Yanique Walker

• Pharmacy in Long Island City, NY
• Providers in Long Island City, NY by specialty
• Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.