Active NPI
Walgreen Eastern Co, Inc
Doing business as Walgreens #01881
- Pharmacy
- Bloomfield, NJ
National Provider Identifier
1629083605
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- License
- RS003821
- Legal business name
- WALGREEN EASTERN CO, INC
- Doing business as
- Walgreens #01881
- Practice address
- 17 Belleville Ave
Bloomfield, NJ 07003 - Phone
- (973) 429-7407
- Fax
- (973) 748-3940
- NPI assigned
- Jul 29, 2006
- Organization subpart
- Yes
- Parent organization
- WALGREENS HOLDING COMPANY
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Virginia Garza
- Title
- Manager
- Phone
- (217) 709-2364
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | RS003821 | NJ | Primary |
| Community/Retail Pharmacy | 3336C0003X |
Addresses
Primary practice location
17 Belleville Ave
Bloomfield, NJ 07003
Mailing address
1901 E Voorhees St
Ms 790
Danville, IL 61834-4509
Phone (217) 709-2364
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3127746 | Other | NJ | NCPDP |
| 4375602 | Medicaid | NJ |
Other names 1
- WALGREENS #01881
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX, NJ
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20071211000174 | TX | Part B Supplier - Centralized Flu Biller | 7618929993 | This NPI is an additional NPI on the enrollment |
| O20100930019219 | NJ | DME Supplier - Pharmacy | 7618929993 | Practice locations: Bloomfield, NJ |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 31D2035782 | Walgreens#01881 | Certificate of waiver | Aug 13, 2027 |
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Walgreens #1881 | Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order) | Accepts assignment |
National Provider Directory
National Provider Directory- Tax ID family
- Walgreens Pharmacy 1869
- 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.
Member of 3
Organizations this organization is a member of, according to the National Provider Directory.
Locations
17 Belleville Ave
Bloomfield, NJ 07003
Phone (973) 429-7407
Practitioners & affiliated clinicians
Practitioners 4
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pharmacist
- Bloomfield, NJ
- NPI 1457633422
-
- Pharmacist
- Bloomfield, NJ
- NPI 1477344026
-
- Pharmacist
- Bloomfield, NJ
- NPI 1811270788
-
- Pharmacist
- Bloomfield, NJ
- NPI 1891077392
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": "1629083605",
"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": "217-709-2364",
"fax_number": "217-709-2344"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17 BELLEVILLE AVE",
"city": "BLOOMFIELD",
"state": "NJ",
"postal_code": "07003",
"telephone_number": "973-429-7407",
"fax_number": "973-748-3940"
}
],
"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": "GARZA",
"authorized_official_first_name": "VIRGINIA",
"authorized_official_title_or_position": "MANAGER",
"authorized_official_telephone_number": "217-709-2364"
},
"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": "RS003821",
"primary": true
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCPDP",
"identifier": "3127746",
"state": "NJ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4375602",
"state": "NJ"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "WALGREENS #01881",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "WALGREENS #01881",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Bloomfield, 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.