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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

WALGREEN EASTERN CO INC
NPI 1417472853
Pharmacy in Old Orchard Beach, ME

Active since August 07, 2017CLIA 20D2200374 · Waiver
15 SACO AVE, OLD ORCHARD BEACH, ME 04064(207) 934-1000(207) 934-0921 Get Directions Write a Review

NPPES record last updated: August 6, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 6, 2026, Jun 2, 2026, May 12, 2026 and 4 more (7 updates tracked since 2017).

About Walgreen Eastern Co Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WALGREEN EASTERN CO INC (NPI 1417472853), doing business as Walgreens #18119, is a healthcare organization registered as a pharmacy in Old Orchard Beach, Maine and active in the NPI registry since August 2017. The organization holds a CLIA Waiver certificate valid through November 15, 2026 and lists Jennifer Ponce, Manager, as its authorized official.

NPPES Registry Identity

NPI1417472853
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NameWALGREEN EASTERN CO INC
Location Address15 SACO AVEOld Orchard Beach, ME 04064-2279
Mailing Address1901 E Voorhees StDanville, IL 61834-4515 · (217) 709-2351 · Fax (217) 709-2344
Phone(207) 934-1000
Fax(207) 934-0921
Organization SubpartYesParent: Walgreens Holding Company
Authorized OfficialJennifer PonceManager · (847) 527-2489
Enumeration DateAugust 7, 2017
Last NPPES UpdateAugust 6, 20267 updates tracked since enumeration
NPPES CertifiedAugust 6, 2026
✔ NPI 1417472853 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacySuppliers
Taxonomy Code333600000X
Definition
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.
Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X
Also ListedPharmacy · Community/Retail PharmacyTaxonomy 3336C0003X
15 SACO AVE, Old Orchard Beach, ME 04064
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Other Names 1

Doing Business AsWalgreens #18119

Other Identifiers 2

Medicaid1417472853ME
OtherPH50001636ME · Board Of Pharmacy

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arkansas Health & Wellness and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 20D2200374

Walgreens #18119 · Old Orchard Beach, ME
Active · expires Nov 15, 2026
CLIA Number20D2200374
Laboratory TypePharmacy
Certificate Effective DateNovember 16, 2024
Certificate Expiration DateNovember 15, 2026
Laboratory DirectorHeidi L. Shaw
Laboratory Phone(207) 934-1000
Laboratory LocationWalgreens #1811915 Saco Ave, Old Orchard Beach, ME 04064
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
150 services150 patients
Influenza vaccine split virus, preservative free 90662
The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.
109 services109 patients
Influenza vaccine, inactivated 90653
The Influenza vaccine, inactivated, is a shot given to protect against the flu. It contains killed virus particles that help your body build immunity to the flu. It's recommended annually to keep your protection up-to-date. It's safe for ages 6 months and up.
27 services27 patients

Medical Equipment Supplier Medicare DMEPOS 7

Medicare supplier enrollment and the product categories Walgreens #18119 carries, from the Medicare DMEPOS supplier directory.

Walgreens #18119

DMEPOS supplier · Old Orchard Beach, MEOperated by Walgreen Co
✔

Accepts Medicare assignment

Walgreens #18119 agrees to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients are not billed beyond the standard deductible and coinsurance.

PTAN (Medicare Supplier Number)20400569
Medicare Participant SinceMarch 1, 2022
Supplier Location15 Saco AveOld Orchard Beach, ME 04064
Phone(207) 934-1000
Supplier Specialties
Pharmacy

Medicare Product Categories

Epoetin
Epoetin is a man-made version of human erythropoietin (EPO)
Immunosuppressive Drugs
Immunosuppressive drugs require dosage, frequency, and route of administration to prevent or treat the rejection of an organ transplant
Infusion Drugs
Nebulizer Drugs
Albuterol, levalbuterol, and metaproterenol are all short-acting bronchodilators with beta-adrenergic stimulatory effect
Oral Anticancer Drugs
FDA anticancer drugs
Oral Antiemetic Drugs
FDA antiemetic drugs
Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JULIE ANNE KITTREDGE PHARM D
Pharmacist
15 SACO AVE
OLD ORCHARD BEACH, ME 04064
York County (207) 797-4351
MRS. BETH N KERBEL PHARM.D,
Pharmacist
15 SACO AVE, RITE AID PHARMACY
OLD ORCHARD BEACH, ME 04064
York County (207) 934-1000
MRS. KRISTIN L HARRIS PHARMD
Pharmacist
15 SACO AVE
OLD ORCHARD BEACH, ME 04064
York County (207) 934-1000
DR. RYAN M BLANKS PHARM D
Pharmacist
15 SACO AVE
OLD ORCHARD BEACH, ME 04064
York County (207) 934-1000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Walgreen Eastern Co Inc's NPI number?

The NPI number for Walgreen Eastern Co Inc is 1417472853. It was assigned to this organization in the NPPES registry on August 7, 2017. The provider is doing business as Walgreens #18119.

Where is Walgreen Eastern Co Inc located?

Walgreen Eastern Co Inc is located at 15 Saco Ave, Old Orchard Beach, ME 04064. The listed phone number is (207) 934-1000.

What is Walgreen Eastern Co Inc's specialty?

The primary specialty registered for this NPI is Pharmacy with taxonomy code 333600000X.

Does Walgreen Eastern Co Inc accept Medicare assignment for medical equipment?

Yes. As a Medicare medical equipment supplier, Walgreens #18119 accepts Medicare assignment: the supplier accepts the Medicare-approved amount as payment in full for covered equipment and supplies.

Does Walgreen Eastern Co Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 20D2200374) is associated with this NPI, valid through November 15, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Walgreen Eastern Co Inc accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter Health of Delaware, Ambetter from Absolute Total Care and Ambetter from Arkansas Health & Wellness and 38 other insurers list Walgreen Eastern Co Inc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Walgreen Eastern Co Inc was last updated on August 6, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.