NPIMap

Organization Active NPI

Walgreens Specialty Pharmacy LLC

  • Pharmacy
  • Morristown, NJ
National Provider Identifier
1679526974
Registry record updated Dec 31, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
28RS00656500 Issued in NJ
Legal business name
WALGREENS SPECIALTY PHARMACY LLC
Practice address
412 Mount Kemble Ave
Suite 300N
Morristown, NJ 07960-6666
Phone
(800) 876-4545
NPI assigned
May 18, 2006
Organization subpart
Yes
Parent organization
WALGREENS BOOTS ALLIANCE INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 31, 2015

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

Authorized official

Name
Mr. Alan T Nielsen
Title
Treasurer
Phone
(847) 315-3523

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 28RS00656500 NJ Primary
Specialty Pharmacy 3336S0011X

Addresses

Primary practice location

412 Mount Kemble Ave
Suite 300N
Morristown, NJ 07960-6666

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
0097586MedicaidNJ
3144247OtherNCPDP

Other names 1

  • Walgreens Specialty Pharmacy #12313 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

412 Mount Kemble Ave
Ste 300N
Morristown, NJ 07960
Phone (800) 876-4545

NPI Registry JSON

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1451520000000",
    "number": "1679526974",
    "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": "412 MOUNT KEMBLE AVE",
            "address_2": "SUITE 300N",
            "city": "MORRISTOWN",
            "state": "NJ",
            "postal_code": "079606666",
            "telephone_number": "800-876-4545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALGREENS SPECIALTY PHARMACY LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WALGREENS BOOTS ALLIANCE INC",
        "enumeration_date": "2006-05-18",
        "last_updated": "2015-12-31",
        "status": "A",
        "authorized_official_last_name": "NIELSEN",
        "authorized_official_first_name": "ALAN",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "847-315-3523",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NJ",
            "license": "28RS00656500",
            "primary": true
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0097586",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "3144247",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Walgreens Specialty Pharmacy #12313",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Morristown, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2015; 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.