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Contact Information

WALGREENS SPECIALTY PHARMACY LLC
130 ENTERPRISE DR
PITTSBURGH, PA15275
 Phone: 412-413-8000
 Fax: 877-231-8302
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
 

Durable Medical Equipment & Medical Supplies

332B00000X 54 Other Medical Supply Company
 

Home Infusion Therapy Pharmacy

3336H0001X 58 Medical Supply Company with Pharmacist
 

Specialty Pharmacy

3336S0011X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for WALGREENS SPECIALTY PHARMACY LLC

NPI Number 1972560688
LBN Legal business name WALGREENS SPECIALTY PHARMACY LLC
Authorized official JENNIFER PONCE - (MANAGER)
Entity Organization
Organization subpart 1 Yes
Enumeration date 04/27/2006
Last updated 09/30/2024 - More than a year ago
Identifiers
PA License # PP415372L
AK Medicaid 1028415
AL Medicaid 164561
AR Medicaid 163032407
AZ Medicaid 875403
CA Medicaid 1972560688
CO Medicaid 85885851
CT Medicaid 003135804
DC Medicaid 81777100
DE Medicaid 250622245
GA Medicaid 003159944A
HI Medicaid 779978
IA Medicaid 1972560688
ID Medicaid 1972560688
IN Medicaid 200463010A
KS Medicaid 200333400A
KY Medicaid 7100162270
LA Medicaid 2202847
MA Medicaid 110103221B
MD Medicaid 4048229-00
ME Medicaid 1972560688
MI Medicaid 1972560688
MN Medicaid 1972560688
MO Medicaid 1972560688
MS Medicaid 04755357
MT Medicaid 214642
NC Medicaid 0395461
ND Medicaid 1482567
NE Medicaid 10026155500
NH Medicaid 3102009
NJ Medicaid 0039683
NM Medicaid 12779024
NV Medicaid 100512960
NY Medicaid 03904592
OH Medicaid 0216524
OK Medicaid 200094500A
OR Medicaid 500603393
PA Medicaid 001963828-0008
RI Medicaid WA95680
SC Medicaid 7P372L
TN Medicaid 3974157
TX Medicaid 580138
UT Medicaid 1972560688
VA Medicaid 1972560688
VT Medicaid 1010753
WA Medicaid P11046424
WI Medicaid 100002237
WV Medicaid 6001307000
WY Medicaid 131971000
Other 3974157 NCPDP
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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