Organization
WALGREENS SPECIALTY PHARMACY LLC
Active
Parent organization
WALGREENS BOOTS ALLIANCE INC
Other names
Walgreens Specialty Pharmacy #16287
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
130 ENTERPRISE DR, PITTSBURGH, PA 15275
(412) 413-8000
(877) 231-8302
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
—
—
333600000X
Pharmacy
Primary
PP415372L
PA
3336H0001X
Home Infusion Therapy Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001963828-0008
—
PA
05
—
003135804
—
CT
05
—
003159944A
—
GA
05
—
0039683
—
NJ
05
—
0216524
—
OH
05
—
03904592
—
NY
05
—
0395461
—
NC
05
—
04755357
—
MS
05
—
100002237
—
WI
05
—
10026155500
—
NE
05
—
100512960
—
NV
05
—
1010753
—
VT
05
—
1028415
—
AK
05
—
110103221B
—
MA
05
—
12779024
—
NM
05
—
131971000
—
WY
05
—
1482567
—
ND
05
—
163032407
—
AR
05
—
164561
—
AL
05
—
1972560688
—
CA
05
—
1972560688
—
IA
05
—
1972560688
—
ID
05
—
1972560688
—
ME
05
—
1972560688
—
MI
05
—
1972560688
—
MN
05
—
1972560688
—
MO
05
—
1972560688
—
UT
05
—
1972560688
—
VA
05
—
200094500A
—
OK
05
—
200333400A
—
KS
05
—
200463010A
—
IN
05
—
214642
—
MT
05
—
2202847
—
LA
05
—
250622245
—
DE
05
—
3102009
—
NH
01
—
3974157
NCPDP
—
05
—
3974157
—
TN
05
—
4048229-00
—
MD
05
—
500603393
—
OR
05
—
580138
—
TX
05
—
6001307000
—
WV
05
—
7100162270
—
KY
05
—
779978
—
HI
05
—
7P372L
—
SC
05
—
81777100
—
DC
05
—
85885851
—
CO
05
—
875403
—
AZ
05
—
P11046424
—
WA
05
—
WA95680
—
RI
Enumeration date
04/27/2006
Last updated
09/30/2024
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us