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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 1750396834
Pharmacy in Yonkers, NY

Active since July 29, 2006CLIA 33D2294042 · Waiver
1230 NEPPERHAN AVE, YONKERS, NY 10703(914) 969-7944 Get Directions Write a Review

NPPES record last updated: September 24, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Sep 24, 2026, Oct 27, 2023, Feb 28, 2022 and 1 more (4 updates tracked since 2018).

About Walgreen Eastern Co Inc NPPES

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

WALGREEN EASTERN CO INC (NPI 1750396834), doing business as Walgreens #02122, is a healthcare organization registered as a pharmacy in Yonkers, New York and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through March 26, 2027 and lists Jennifer Ponce, Manager, as its authorized official.

NPPES Registry Identity

NPI1750396834
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NameWALGREEN EASTERN CO INC
Location Address1230 NEPPERHAN AVEYonkers, NY 10703-1413
Mailing Address1901 E Voorhees St, Ms 790Danville, IL 61834-4515 · (847) 527-2489 · Fax (217) 709-2344
Phone(914) 969-7944
Organization SubpartYesParent: Walgreens Holding Company
Authorized OfficialJennifer PonceManager · (847) 527-2489
Enumeration DateJuly 29, 2006
Last NPPES UpdateSeptember 24, 20264 updates tracked since enumeration
NPPES CertifiedSeptember 24, 2026
✔ NPI 1750396834 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacySuppliers
Taxonomy Code333600000X
License✔ Licensed in NY · 20128
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
1230 NEPPERHAN AVE, Yonkers, NY 10703
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Other Names 1

Doing Business AsWalgreens #02122

Other Identifiers 2

Medicaid01121755NY
Other3393523Other Id Number-commercial Number

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 ›

Medicare Participation & PECOS CMS

Medicare enrollment and revalidation status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Walgreen Eastern Co Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by November 30, 2026

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateNew YorkEnrollment IDO20100930036487DME · PharmacyDue dateNovember 30, 2026
Source: CMS Revalidation Due Date List, October 2026 release.

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 33D2294042

Walgreens No 02122 · Yonkers, NY
Active · expires Mar 26, 2027
CLIA Number33D2294042
Laboratory TypePharmacy
Certificate Effective DateNovember 17, 2023
Certificate Expiration DateMarch 26, 2027
Laboratory DirectorDr. Zeiad A. Fakhouri
Laboratory Phone(914) 969-7944
Laboratory LocationWalgreens No 021221230 Nepperhan Ave, Yonkers, NY 10703
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 5

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.
373 services369 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.
234 services234 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.
123 services123 patients
Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677
The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.
25 services25 patients
Administration of pneumococcal vaccine G0009
The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.
25 services25 patients

Medical Equipment Supplier Medicare DMEPOS 7

Medicare supplier enrollment and the product categories Walgreens #2122 carries, from the Medicare DMEPOS supplier directory.

Walgreens #2122

DMEPOS supplier · Yonkers, NYOperated by Walgreen Eastern Co Inc
✔

Accepts Medicare assignment

Walgreens #2122 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)20338505
Medicare Participant SinceJanuary 1, 2023
Supplier Location1230 Nepperhan AveYonkers, NY 10703
Phone(914) 969-7944
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 13

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

DR. ANTONIA DEMARINIS PHARM D
Pharmacist
1230 NEPPERHAN AVE
YONKERS, NY 10703
Westchester County (914) 969-7944
RAYA KEIR PHARMD
Pharmacist
1230 NEPPERHAN AVE
YONKERS, NY 10703
Westchester County (914) 969-7944
DR. ALANA PALERMO PHARM D
Pharmacist
1230 NEPPERHAN AVE
YONKERS, NY 10703
Westchester County (914) 969-7944
JIMMY HONG
Pharmacist
1230 NEPPERHAN AVE
YONKERS, NY 10703
Westchester County (914) 969-7944
EDWARD ADUSEI POKU
Pharmacist
1230 NEPPERHAN AVE
YONKERS, NY 10703
Westchester County (914) 969-7944
DR. JAMES N KELSO PHARM D.
Pharmacist
1230 NEPPERHAN AVE
YONKERS, NY 10703
Westchester County (914) 969-7944
DR. ZACHARY ARANBAYEV PHARMD
Pharmacist
1230 NEPPERHAN AVE
YONKERS, NY 10703
Westchester County (914) 969-7944
MR. JOHN A CAPONETTO PHARMACIST
Pharmacist
1230 NEPPERHAN AVE
YONKERS, NY 10703
Westchester County (914) 969-7944

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 1750396834. It was assigned to this organization in the NPPES registry on July 29, 2006. The provider is doing business as Walgreens #02122.

Where is Walgreen Eastern Co Inc located?

Walgreen Eastern Co Inc is located at 1230 Nepperhan Ave, Yonkers, NY 10703. The listed phone number is (914) 969-7944.

What is Walgreen Eastern Co Inc's specialty?

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

Is Walgreen Eastern Co Inc enrolled in Medicare?

Yes. Walgreen Eastern Co Inc is registered in the Medicare PECOS enrollment system.

When is Walgreen Eastern Co Inc's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare DME enrollment for this organization (New York, Pharmacy) is due for revalidation by November 30, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

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

Yes. As a Medicare medical equipment supplier, Walgreens #2122 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 33D2294042) is associated with this NPI, valid through March 26, 2027. 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 36 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 September 24, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 42 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.