Active NPI
Walgreen Co
- Pharmacy
- White Plains, NY
National Provider Identifier
1881808764
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- License
- 028403
- Legal business name
- WALGREEN CO
- Doing business as
- Walgreens Specialty Pharmacy #20583
- Practice address
- 66 E Post Rd Ste 1
White Plains, NY 10601-4622 - Phone
- (914) 686-0005
- Fax
- (914) 686-2907
- NPI assigned
- May 9, 2007
- Organization subpart
- Yes
- Parent organization
- WALGREENS BOOTS ALLIANCE INC
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | 028403 | NY | Primary |
| Clinic Pharmacy | 3336C0002X | |||
| Community/Retail Pharmacy | 3336C0003X | |||
| Specialty Pharmacy | 3336S0011X |
Addresses
Primary practice location
66 E Post Rd Ste 1
White Plains, NY 10601-4622
Mailing address
1901 E Voorhees St
Ms #790
Danville, IL 61834-4509
Phone (847) 527-2489
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02920198 | Medicaid | NY | |
| 3354064 | Other | NCPDP |
Other names 1
- Walgreens Specialty Pharmacy #20583
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070917000779 | TX | Part B Supplier - Centralized Flu Biller | 0941278253 | This NPI is an additional NPI on the enrollment |
National Provider Directory
National Provider Directory- Part of
- Walgreens Holding Company
Member of 16
Organizations this organization is a member of, according to the National Provider Directory.
-
- Home Infusion Therapy Pharmacy
- Sauk Rapids, MN
- NPI 1891746111
Member Of
-
- Home Infusion Therapy Pharmacy
- Nashville, TN
- NPI 1326279746
Member Of
Locations
66 E Post Rd
Ste 1
White Plains, NY 10601
Phone (914) 259-2774
Ownership & related parties
Parent organization (reported in NPPES) 1
This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.
-
- Pharmacist
- Syosset, NY
- NPI 1346619889
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178668800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1733356800000",
"number": "1881808764",
"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": "66 E POST RD STE 1",
"city": "WHITE PLAINS",
"state": "NY",
"postal_code": "106014622",
"telephone_number": "914-686-0005",
"fax_number": "914-686-2907"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WALGREEN CO",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "WALGREENS BOOTS ALLIANCE INC",
"enumeration_date": "2007-05-09",
"last_updated": "2024-12-05",
"certification_date": "2024-12-05",
"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": "NY",
"license": "028403",
"primary": true
},
{
"code": "3336C0002X",
"taxonomy_group": "",
"desc": "Pharmacy, Clinic Pharmacy",
"state": null,
"license": null,
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": false
},
{
"code": "3336S0011X",
"taxonomy_group": "",
"desc": "Pharmacy, Specialty Pharmacy",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02920198",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCPDP",
"identifier": "3354064",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Walgreens Specialty Pharmacy #20583",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in White Plains, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 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.