Organization
WALGREENS SPECIALTY PHARMACY LLC
Active
Parent organization
WALGREENS BOOTS ALLIANCE INC
Other names
Walgreens Specialty Pharmacy #15438
Organization subpart
Yes
Provider details
NPI number
Legal business name
WALGREENS BOOTS ALLIANCE INC
Authorized official
JENNIFER PONCE (MANAGER)
(847) 527-2489
Entity
Organization
Contact information
Practice address
41460 HAGGERTY CIR S, CANTON, MI 48188
(888) 282-5166
(888) 570-4700
Mailing address
1901 E VOORHEES ST, MS #790, DANVILLE, IL 61834-4509
(847) 527-2489
(217) 709-2344
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
5301007754
MI
3336H0001X
Home Infusion Therapy Pharmacy
—
—
3336S0011X
Specialty Pharmacy
5301007754
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003788101
—
NV
05
—
0213639
—
MT
05
—
0216482
—
OH
05
—
100066062
—
WI
05
—
1023139
—
VT
05
—
118687600
—
WY
05
—
1942303110
—
IA
05
—
1942303110
—
ID
05
—
1942303110
—
MI
05
—
1942303110
—
MN
05
—
1942303110
—
MO
05
—
1942303110
—
UT
05
—
19638280007
—
PA
05
—
200333400D
—
KS
05
—
2008032
—
WA
05
—
201052500A
—
IN
01
—
2348046
NCPDP
—
05
—
2348046
—
TN
05
—
551206900
—
MD
05
—
7100151430
—
KY
05
—
9000182454
—
CO
Enumeration date
09/06/2006
Last updated
09/02/2025
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