NPIMap

Organization Active NPI

Walgreens Specialty Pharmacy LLC

Doing business as Walgreen Specialty Pharmacy #12314

  • Specialty Pharmacy
  • Beaverton, OR
National Provider Identifier
1972847044
Registry record updated Aug 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Specialty PharmacyTaxonomy code 3336S0011X
Legal business name
WALGREENS SPECIALTY PHARMACY LLC
Doing business as
Walgreen Specialty Pharmacy #12314
Practice address
9775 SW Gemini Dr Ste 1
Beaverton, OR 97008
Phone
(503) 643-8511
NPI assigned
Nov 15, 2012
Last updated
Aug 31, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
WALGREEN COAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 31, 2018

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

Authorized official

Name
Alyssa Sweeten
Title
Manager
Phone
(217) 709-2386

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU
Specialty Pharmacy 3336S0011X NU Primary

Addresses

Primary practice location

9775 SW Gemini Dr Ste 1
Beaverton, OR 97008

Mailing address

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

Other names 1

  • WALGREEN SPECIALTY PHARMACY #12314 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 01007

Other organizations with this tax ID 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1352937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1535673600000",
    "number": "1972847044",
    "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": "9775 SW GEMINI DR STE 1",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "97008",
            "telephone_number": "503-643-8511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALGREENS SPECIALTY PHARMACY LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WALGREEN CO",
        "enumeration_date": "2012-11-15",
        "last_updated": "2018-08-31",
        "status": "A",
        "authorized_official_last_name": "SWEETEN",
        "authorized_official_first_name": "ALYSSA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "217-709-2386"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WALGREEN SPECIALTY PHARMACY #12314",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "WALGREEN SPECIALTY PHARMACY #12314",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Beaverton, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2018; 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.