NPIMap

Organization Active NPI

Walgreen Eastern Co, Inc

Doing business as Walgreens #03549

  • Pharmacy
  • Lindenwold, NJ
National Provider Identifier
1174538169
Registry record updated Jul 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
RS005238 Issued in NJ
Legal business name
WALGREEN EASTERN CO, INC
Doing business as
Walgreens #03549
Practice address
630 Chews Landing Rd
Lindenwold, NJ 08021
Phone
(856) 566-0099
Fax
(856) 566-0978
NPI assigned
Jul 29, 2006
Last updated
Jul 10, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
WALGREENS HOLDING COMPANYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 10, 2026

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

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X RS005238 NJ Primary
Community/Retail Pharmacy 3336C0003X

Addresses

Primary practice location

630 Chews Landing Rd
Lindenwold, NJ 08021

Mailing address

1901 E Voorhees St
Ms 790
Danville, IL 61834-4509
Phone (217) 709-2351

Other identifiers 2

IdentifierTypeStateIssuer
6784500MedicaidNJ
3137393OtherNJNCPDP

Other names 1

  • WALGREENS #03549 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, NJ3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20071211000174 TX Part B Supplier - Centralized Flu Biller 7618929993 This NPI is an additional NPI on the enrollment
O20100930068520 NJ DME Supplier - Pharmacy 7618929993 Practice locations: Lindenwold, NJ
O20210323001432 NJ Part B Supplier - Independent Clinical Laboratory 7618929993 11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Orange, NJ; West Caldwell, NJ; Plainfield, NJ; Perth Amboy, NJ; Lindenwold, NJ; Linden, NJ; Fair Lawn, NJ; Elmwood Park, NJ…

Other NPIs on the same Medicare enrollment 11

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
31D2034973Walgreens #03549630 Chews Landing Road, Lindenwold, NJ 08021Certificate of waiverApr 4, 2027

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Walgreens #03549630 Chews Landing Rd, Lindenwold, NJ 08021-6756(856) 566-0099 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order) Accepts assignmentParticipating since Jan 1, 2023

National Provider Directory

National Provider Directory
Tax ID family
Walgreens Pharmacy 2267338 organizations share this tax ID, including this one
Part of
Walgreens Holding Company

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Member of 3

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

Locations

630 Chews Landing Rd
Lindenwold, NJ 08021
Phone (856) 566-0099

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1154131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783641600000",
    "number": "1174538169",
    "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": "630 CHEWS LANDING RD",
            "city": "LINDENWOLD",
            "state": "NJ",
            "postal_code": "08021",
            "telephone_number": "856-566-0099",
            "fax_number": "856-566-0978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALGREEN EASTERN CO, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WALGREENS HOLDING COMPANY",
        "enumeration_date": "2006-07-29",
        "last_updated": "2026-07-10",
        "certification_date": "2026-07-10",
        "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": "NJ",
            "license": "RS005238",
            "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": "6784500",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "3137393",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WALGREENS #03549",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "WALGREENS #03549",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lindenwold, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.