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Organization
WALGREENS SPECIALTY PHARMACY LLC
Active
Organization
WALGREENS SPECIALTY PHARMACY LLC
Active
Parent organization
WALGREENS BOOTS ALLIANCE INC
Other names
AllianceRX Walgreens Prime #12314
Organization subpart
Yes
Provider details
NPI number
Legal business name
WALGREENS BOOTS ALLIANCE INC
Authorized official
KIRA TAYLOR (MANAGER)
(217) 709-2351
Entity
Organization
Contact information
Practice address
9775 SW GEMINI DR, STE 1, BEAVERTON, OR 97008
(866) 202-4014
Mailing address
1901 E VOORHEES ST, MS 790, DANVILLE, IL 61834-4509
(217) 709-2386
(217) 709-2344
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
RP-0002419
OR
3336H0001X
Home Infusion Therapy Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0216467
—
OH
05
—
1021135430001
—
PA
05
—
1028445
—
AK
05
—
1092434
—
WA
05
—
1669668752
—
IA
05
—
1669668752
—
ID
05
—
1669668752
—
MI
05
—
1669668752
—
MN
05
—
1669668752
—
MT
05
—
1669668752
—
UT
05
—
1669668752
—
VA
05
—
200135400A
—
OK
05
—
200333400E
—
KS
05
—
200923000A
—
IN
05
—
278926
—
OR
05
—
320618
—
AZ
05
—
37104811
—
NM
01
—
3842944
NCPDP
—
05
—
3842944
—
TN
05
—
44039751
—
CO
05
—
457263
—
ND
05
—
554205700
—
MD
05
—
685274-01
—
HI
05
—
7100277090
—
KY
05
—
7R2419
—
SC
Enumeration date
09/21/2007
Last updated
05/11/2021
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