NPIMap

Organization Active NPI

Walgreen Specialty Pharmacy, LLC

  • Pharmacy
  • Frisco, TX
National Provider Identifier
1598066243
Registry record updated Sep 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
WALGREEN SPECIALTY PHARMACY, LLC
Practice address
10530 John Elliott Drive
Ste. 100
Frisco, TX 75033-0000
Phone
(214) 387-3500
NPI assigned
Nov 11, 2010
Organization subpart
Yes
Parent organization
WALGREENS BOOTS ALLIANCE INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 30, 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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X Primary

Addresses

Primary practice location

10530 John Elliott Drive
Ste. 100
Frisco, TX 75033-0000

Mailing address

1901 E Voorhees St
Ms 792
Danville, IL 61834-4509
Phone (217) 709-2386

Other identifiers 1

IdentifierTypeStateIssuer
5903023OtherTXNCPDP

Other names 1

  • Walgreens Specialty Pharmacy #15443 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 Holding Company

Other organizations with this tax ID 16

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

View all 16

Locations

1901 E Voorhees St
#792
Danville, IL 61834

NPI Registry JSON

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

{
    "created_epoch": "1289433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727654400000",
    "number": "1598066243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 E VOORHEES ST",
            "address_2": "MS 792",
            "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 ELLIOTT DRIVE",
            "address_2": "STE. 100",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750330000",
            "telephone_number": "214-387-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALGREEN SPECIALTY PHARMACY, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WALGREENS BOOTS ALLIANCE INC",
        "enumeration_date": "2010-11-11",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "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": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "5903023",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Walgreens Specialty Pharmacy #15443",
            "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 Sep 30, 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.