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Active NPI 1982128088 Organization (Entity Type 2) Subpart Facility

Walgreen Eastern Co Inc

Pharmacy • Gorham, ME

Parent Organization: Walgreens Holding Company

About Walgreen Eastern Co Inc NPI 1982128088 Summary

Walgreen Eastern Co Inc is a verified healthcare organization specializing in Pharmacy operating in Gorham, ME. Located at 120 MAIN ST, this facility provides patient care and medical services under National Provider Identifier (NPI) 1982128088.

Walgreen Eastern Co Inc operates as a subpart facility of Walgreens Holding Company. Administrative operations and authorized compliance are overseen by Jennifer Ponce (Manager).

The facility is associated with 1 linked healthcare practitioner providing clinical services.

Facility Location & Contact Primary Location

Facility Address

120 Main St

Gorham, ME 040381306

Telephone 2078393160
Fax 2078397038

Authorized Official Information

Authorized Contact Name

Jennifer Ponce

Title / Role

Manager

Official Telephone

8475272489

Facility Classifications & Specialties

Pharmacy Primary Taxonomy

NUCC Taxonomy Code: 333600000X

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.

Durable Medical Equipment & Medical Supplies

NUCC Taxonomy Code: 332B00000X

A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.

Pharmacy - Community/Retail Pharmacy

NUCC Taxonomy Code: 3336C0003X

A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

Affiliated Practitioners & Clinicians

Healthcare professionals and specialists practicing at this facility or affiliated group locations

1 Linked
Stanley Lee NPI 1962718247

Pharmacist

Gorham, ME

View Practitioner Profile →

Facility & Registry History Timeline

Chronological log of verified NPI organization updates, branch relocations, and registry updates

18 Historical Events
🏛️
Organization / Clinic Name Updated August 06, 2026

Operating as WALGREEN EASTERN CO INC

🏛️
Organization / Clinic Name Updated June 02, 2026

Operating as WALGREEN CO

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 02, 2026

Durable Medical Equipment & Medical Supplies

📍
Updated Business Mailing Address January 14, 2026

Registered at 1901 E VOORHEES ST, DANVILLE, IL 618344515 (Tel: 2177092351)

🏛️
Organization / Clinic Name Updated January 14, 2026

Operating as WALGREEN EASTERN CO INC

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) January 14, 2026

Pharmacy

📍
Updated Business Mailing Address June 09, 2022

Registered at 1901 E VOORHEES ST, MS 790, DANVILLE, IL 618344509 (Tel: 2177092351)

NPI Profile Active January 31, 2018

NPI status registered as active in NPPES database

📍
Updated Practice Location January 31, 2018

Registered at 120 MAIN ST, GORHAM, ME 040381306 (Tel: 2078393160)

📍
Updated Business Mailing Address January 31, 2018

Registered at 1901 E VOORHEES ST # MS 790, DANVILLE, IL 618344509 (Tel: 2177092386)

🏛️
Organization / Clinic Name Updated January 31, 2018

Operating as WALGREEN CO

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) January 31, 2018

Durable Medical Equipment & Medical Supplies

NPI Profile Active July 31, 2017

NPI status registered as active in NPPES database

📍
Updated Practice Location July 31, 2017

Registered at 120 MAIN ST, GORHAM, ME 040381306 (Tel: 2078393160)

📍
Updated Business Mailing Address July 31, 2017

Registered at 1901 E VOORHEES ST # MS 790, DANVILLE, IL 618344509 (Tel: 2177092386)

🏛️
Organization / Clinic Name Updated July 31, 2017

Operating as WALGREEN CO

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 31, 2017

Durable Medical Equipment & Medical Supplies

🟢
Initial NPI Registration & Enumeration July 31, 2017

First registered as active Healthcare Organization in NPPES Database.

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NPI Organization Metadata

NPI Number: 1982128088
Entity Type:
Organization Organization (Hospital, Clinic, Group Practice) (Type 2 NPI)
Enumeration Date: July 31, 2017
Last Update: August 06, 2026

Mailing Address

1901 E Voorhees St

Danville, IL 618344515

Phone: 2177092351

Public Domain Record This organization profile is sourced from public domain datasets published by CMS and NPPES under FOIA.
⚠️ Medical Disclaimer

Facility details are provided for public information only. In case of a medical emergency, call 911 immediately.