NPIMap

Organization Active NPI

Walgreens Specialty Pharmacy LLC

Doing business as Walgreens Specialty Pharmacy #15443

  • Pharmacy
  • Frisco, TX
National Provider Identifier
1851463087
Registry record updated Mar 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
14412 Issued in TX
Legal business name
WALGREENS SPECIALTY PHARMACY LLC
Doing business as
Walgreens Specialty Pharmacy #15443
Practice address
10530 John W Elliott Dr
Ste 100
Frisco, TX 75033
Phone
(800) 424-9002
Fax
(800) 874-9179
NPI assigned
Nov 14, 2006
Last updated
Mar 4, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
WALGREENS BOOTS ALLIANCEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 4, 2026

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X 14412 TX Primary
Home Infusion Therapy Pharmacy 3336H0001X
Specialty Pharmacy 3336S0011X 14412 TX

Addresses

Primary practice location

10530 John W Elliott Dr
Ste 100
Frisco, TX 75033

Mailing address

1901 E Voorhees St
Ms 790
Danville, IL 61834-4509
Phone (847) 527-2489

Other identifiers 31

IdentifierTypeStateIssuer
1851463087MedicaidIA
1851463087MedicaidMI
1851463087MedicaidWI
2013289MedicaidWA
466694MedicaidTX
7T4412MedicaidSC
07033855MedicaidMS
185350407MedicaidAR
200390000AMedicaidIN
2204947MedicaidLA
96722339MedicaidNM
1028472MedicaidAK
200037560AMedicaidOK
3124086MedicaidNH
498604MedicaidAZ
119788601MedicaidWY
1851463087MedicaidVA
1851463087MedicaidID
491055MedicaidTN
00196328280006MedicaidPA
1851463087MedicaidNV
1851463087MedicaidMT
007571MedicaidHI
0216495MedicaidOH
1851463087MedicaidMN
4591055OtherNCPDP
1851463087MedicaidSD
1851463087MedicaidUT
500638341MedicaidOR
554204900MedicaidMD
7100151520MedicaidKY

Other names 1

  • Walgreens Specialty Pharmacy #15443 Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110801000113 TX DME Supplier - Pharmacy 5597972232 Practice locations: Frisco, TX

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

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

Member of 1

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

NPI Registry JSON

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1772582400000",
    "number": "1851463087",
    "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": "847-527-2489",
            "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 100",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "75033",
            "telephone_number": "800-424-9002",
            "fax_number": "800-874-9179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALGREENS SPECIALTY PHARMACY LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WALGREENS BOOTS ALLIANCE",
        "enumeration_date": "2006-11-14",
        "last_updated": "2026-03-04",
        "certification_date": "2026-03-04",
        "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": "TX",
            "license": "14412",
            "primary": true
        },
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "TX",
            "license": "14412",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
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            "state": "IA"
        },
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            "issuer": null,
            "identifier": "1851463087",
            "state": "MI"
        },
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            "code": "05",
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            "issuer": null,
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            "state": "WI"
        },
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        },
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        {
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        {
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        },
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        {
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        {
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        {
            "code": "05",
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            "issuer": null,
            "identifier": "1851463087",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
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        {
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        {
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    ],
    "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 Mar 4, 2026; 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.