NPIMap

Organization Active NPI

Walgreens Specialty Pharmacy LLC

Doing business as Walgreens Specialty Pharmacy #15438

  • Specialty Pharmacy
  • Canton, MI
National Provider Identifier
1417284845
Registry record updated Oct 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Specialty PharmacyTaxonomy code 3336S0011X
Legal business name
WALGREENS SPECIALTY PHARMACY LLC
Doing business as
Walgreens Specialty Pharmacy #15438
Practice address
41460 Haggerty Cir S
Canton, MI 48188-2227
Phone
(888) 282-5166
Fax
(734) 929-0342
NPI assigned
Nov 5, 2009
Last updated
Oct 8, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
WALGREEN COAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 8, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jennifer L Ponce
Title
Manager
Phone
(847) 527-2489

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU
Pharmacy 333600000X NU
Specialty Pharmacy 3336S0011X NU Primary
Compounding Pharmacy 3336C0004X NU

Addresses

Primary practice location

41460 Haggerty Cir S
Canton, MI 48188-2227

Mailing address

500 Noblestown Rd
Carnegie, PA 15106-1230

Other names 1

  • Walgreens Specialty Pharmacy #15438 Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Walgreen Specialty Pharmacy LLC17 organizations share this tax ID, including this one
Part of
Walgreens 01007

Other organizations with this tax ID 16

Organizations that report the same tax identification number in the National Provider Directory.

View all 16

Locations

500 Noblestown Rd
Carnegie, PA 15106
Phone (412) 325-6500

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1257379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728345600000",
    "number": "1417284845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 NOBLESTOWN RD",
            "city": "CARNEGIE",
            "state": "PA",
            "postal_code": "151061230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41460 HAGGERTY CIR S",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481882227",
            "telephone_number": "888-282-5166",
            "fax_number": "734-929-0342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALGREENS SPECIALTY PHARMACY LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WALGREEN CO",
        "enumeration_date": "2009-11-05",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A",
        "authorized_official_last_name": "PONCE",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "847-527-2489"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Walgreens Specialty Pharmacy #15438",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Canton, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.