Organization
CYSTIC FIBROSIS SERVICES LLC
Active
Parent organization
WALGREENS BOOTS ALLIANCE
Other names
Walgreens Specialty Pharmacy #16280
Organization subpart
Yes
Provider details
NPI number
Legal business name
WALGREENS BOOTS ALLIANCE
Authorized official
JENNIFER PONCE (MANAGER)
(847) 527-2489
Entity
Organization
Contact information
Practice address
10530 JOHN W ELLIOTT DR, STE 200, FRISCO, TX 75033
(800) 541-4959
(866) 574-1418
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
332B00000X
Durable Medical Equipment & Medical Supplies
22618
TX
333600000X
Pharmacy
Primary
29801
TX
3336H0001X
Home Infusion Therapy Pharmacy
—
—
3336M0002X
Mail Order Pharmacy
22618
TX
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0072006850007
—
PA
05
—
0105009
—
OH
05
—
0215203
—
MT
05
—
0510131
—
NJ
05
—
05779731
—
NM
05
—
0761528
—
IA
05
—
082243600
—
DC
05
—
100043530
—
WI
05
—
100264738-00
—
NE
05
—
100443180B
—
KS
05
—
100798300D
—
OK
05
—
1028469
—
AK
05
—
1030442
—
VT
05
—
1279595
—
LA
05
—
139071600
—
WY
05
—
145295
—
TX
05
—
1477571404
—
CA
05
—
1477571404
—
CT
05
—
1477571404
—
ID
05
—
1477571404
—
MI
05
—
1477571404
—
MN
05
—
1477571404
—
NV
05
—
1477571404
—
SD
05
—
1477571404
—
UT
05
—
1477571404
—
VA
05
—
152683407
—
AR
05
—
201273550A
—
IN
05
—
2041124
—
WA
05
—
21576777
—
CO
05
—
3099359
—
NH
01
—
4528874
NCPDP
—
05
—
4528874
—
TN
05
—
500678751
—
OR
05
—
5124191-00
—
MD
05
—
7100162130
—
KY
05
—
7T2618
—
SC
05
—
967893
—
AZ
Enumeration date
07/17/2006
Last updated
11/11/2024
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