National Provider Identifier Database

WALGREENS SPECIALTY PHARMACY LLC
Pharmacy

A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.


Contact Information

WALGREENS SPECIALTY PHARMACY LLC
9775 SW GEMINI DR
STE 1
BEAVERTON, OR97008
Phone: 866-202-4014
Fax:
Website:
Specialty Taxonomy Code
* Pharmacy 333600000X
Home Infusion Therapy Pharmacy 3336H0001X
Specialty Pharmacy 3336S0011X

* Indicates primary specialty

NPI Profile & details for WALGREENS SPECIALTY PHARMACY LLC

NPI Number 1669668752
Legal business name
LBN
WALGREENS SPECIALTY PHARMACY LLC
Authorized official KIRA TAYLOR - (MANAGER)
Entity Organization
Organization subpart Yes
Enumeration date 09/21/2007
Last updated 05/11/2021 - About 5 years ago
Sole proprietor1 Not specified
Identifiers
  • OR License #: RP-0002419
  • AK Medicaid: 1028445
  • AZ Medicaid: 320618
  • CO Medicaid: 44039751
  • HI Medicaid: 685274-01
  • IA Medicaid: 1669668752
  • ID Medicaid: 1669668752
  • IN Medicaid: 200923000A
  • KS Medicaid: 200333400E
  • KY Medicaid: 7100277090
  • MD Medicaid: 554205700
  • MI Medicaid: 1669668752
  • MN Medicaid: 1669668752
  • MT Medicaid: 1669668752
  • ND Medicaid: 457263
  • NM Medicaid: 37104811
  • OH Medicaid: 0216467
  • OK Medicaid: 200135400A
  • OR Medicaid: 278926
  • PA Medicaid: 1021135430001
  • SC Medicaid: 7R2419
  • TN Medicaid: 3842944
  • UT Medicaid: 1669668752
  • VA Medicaid: 1669668752
  • WA Medicaid: 1092434
  • Other: 3842944 NCPDP

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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