NPIMap

Organization Active NPI

Cystic Fibrosis Services LLC

  • Pharmacy
  • Frisco, TX
National Provider Identifier
1477571404
Registry record updated Nov 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
29801 Issued in TX
Legal business name
CYSTIC FIBROSIS SERVICES LLC
Practice address
10530 John W Elliott Dr
Ste 200
Frisco, TX 75033
Phone
(800) 541-4959
Fax
(866) 574-1418
NPI assigned
Jul 17, 2006
Organization subpart
Yes
Parent organization
WALGREENS BOOTS ALLIANCEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 11, 2024

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

Authorized official

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 22618 TX
Pharmacy 333600000X 29801 TX Primary
Home Infusion Therapy Pharmacy 3336H0001X
Mail Order Pharmacy 3336M0002X 22618 TX
Specialty Pharmacy 3336S0011X

Addresses

Primary practice location

10530 John W Elliott Dr
Ste 200
Frisco, TX 75033

Mailing address

1901 E Voorhees St
Ms 790
Danville, IL 61834-4509
Phone (217) 709-2386

Other identifiers 37

IdentifierTypeStateIssuer
0072006850007MedicaidPA
0510131MedicaidNJ
1028469MedicaidAK
1477571404MedicaidVA
2041124MedicaidWA
500678751MedicaidOR
100798300DMedicaidOK
1279595MedicaidLA
145295MedicaidTX
100443180BMedicaidKS
1477571404MedicaidMN
1477571404MedicaidNV
1477571404MedicaidID
1477571404MedicaidCT
21576777MedicaidCO
0105009MedicaidOH
082243600MedicaidDC
4528874OtherNCPDP
0761528MedicaidIA
1477571404MedicaidSD
201273550AMedicaidIN
100043530MedicaidWI
139071600MedicaidWY
1477571404MedicaidCA
1477571404MedicaidMI
7100162130MedicaidKY
0215203MedicaidMT
05779731MedicaidNM
100264738-00MedicaidNE
1477571404MedicaidUT
152683407MedicaidAR
4528874MedicaidTN
7T2618MedicaidSC
967893MedicaidAZ
1030442MedicaidVT
3099359MedicaidNH
5124191-00MedicaidMD

Other names 1

  • Walgreens Specialty Pharmacy #16280 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930041910 TX DME Supplier - Pharmacy 0840319869 Practice locations: Frisco, TX

National Provider Directory

National Provider Directory
Tax ID family
Cystic Fibrosis Services Inc2 organizations share this tax ID, including this one
Part of
Walgreens Holding Company

Other organizations with this tax ID 1

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

Member of 3

Organizations this organization is a member of, according to the National Provider Directory.

Locations

10530 John W Elliott Dr
Ste 200
Frisco, TX 75033
Phone (800) 541-4959

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731283200000",
    "number": "1477571404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 E VOORHEES ST",
            "address_2": "MS 790",
            "city": "DANVILLE",
            "state": "IL",
            "postal_code": "618344509",
            "telephone_number": "217-709-2386",
            "fax_number": "217-709-2344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10530 JOHN W ELLIOTT DR",
            "address_2": "STE 200",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "75033",
            "telephone_number": "800-541-4959",
            "fax_number": "866-574-1418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CYSTIC FIBROSIS SERVICES LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WALGREENS BOOTS ALLIANCE",
        "enumeration_date": "2006-07-17",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A",
        "authorized_official_last_name": "PONCE",
        "authorized_official_first_name": "JENNIFER",
        "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": "TX",
            "license": "22618",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
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            "license": "29801",
            "primary": true
        },
        {
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            "primary": false
        },
        {
            "code": "3336M0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Mail Order Pharmacy",
            "state": "TX",
            "license": "22618",
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
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            "identifier": "1279595",
            "state": "LA"
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            "state": "KS"
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            "state": "CT"
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            "code": "05",
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            "identifier": "21576777",
            "state": "CO"
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            "code": "05",
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            "identifier": "0105009",
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            "identifier": "082243600",
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        },
        {
            "code": "01",
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            "issuer": "NCPDP",
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        {
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        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Walgreens Specialty Pharmacy #16280",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Frisco, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.