{
  "npi": "1912422288",
  "enumeration_type": "NPI-2",
  "basic": {
    "authorized_official_first_name": "JENNIFER",
    "authorized_official_last_name": "PONCE",
    "authorized_official_telephone_number": "8475272489",
    "authorized_official_title_or_position": "manager",
    "certification_date": "2026-08-06",
    "enumeration_date": "2017-08-08",
    "last_updated": "2026-08-06",
    "organization_name": "WALGREEN EASTERN CO INC",
    "organizational_subpart": "YES",
    "parent_organization_legal_business_name": "WALGREENS HOLDING COMPANY",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "1901 E VOORHEES ST",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "DANVILLE",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "217-709-2344",
      "postal_code": "618344515",
      "state": "IL",
      "telephone_number": "217-709-2351"
    },
    {
      "address_1": "151 MAPLE ST",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "CORNISH",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "207-625-3880",
      "postal_code": "040203103",
      "state": "ME",
      "telephone_number": "207-625-8494"
    }
  ],
  "taxonomies": [
    {
      "code": "332BC3200X",
      "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": ""
    },
    {
      "code": "333600000X",
      "desc": "Pharmacy",
      "license": null,
      "primary": true,
      "state": null,
      "taxonomy_group": ""
    },
    {
      "code": "3336C0003X",
      "desc": "Pharmacy, Community/Retail Pharmacy",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": ""
    }
  ],
  "compliance": {
    "oig_leie_exclusion": {
      "excluded": false,
      "status": "CLEAR",
      "matches": [],
      "totalDbRecords": 84224
    },
    "cms_pecos_eligibility": {
      "note": "Not listed in CMS Order & Referring PECOS file or institutional NPI-2"
    }
  },
  "medicare_utilization": {
    "total_beneficiaries": "12",
    "total_services": "30",
    "total_medicare_allowed_amt": "3282.57",
    "top_hcpcs_services": []
  },
  "enrichment": {
    "plain_english_specialty": "Licensed & Credentialed Suppliers — Pharmacy",
    "certifying_board": "State Medical / Healthcare Licensing Board & National Specialty Board",
    "cms_medicare_crosswalk": [
      {
        "medicare_code": "58",
        "medicare_type": "Medical Supply Company with Pharmacist"
      },
      {
        "medicare_code": "A5",
        "medicare_type": "Pharmacy"
      }
    ]
  }
}