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NPI Code Detail

MEDICARE: WALGREENS SPECIALTY PHARMACY LLC

MEDICARE: WALGREENS SPECIALTY PHARMACY LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13336C0003XCommunity/Retail Pharmacy
2333600000XPharmacy
33336S0011XSpecialty Pharmacy

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
10MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
11MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
12MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
13MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
14MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
15MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
16MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
17MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
18MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
19MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
20MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1619665585
Entity Type Code : Organization
Provider Name (Legal Business Name) : WALGREENS SPECIALTY PHARMACY LLC
Provider Business Mailing Address
First Line : 1901 E VOORHEES ST # MS 790
Second Line :
City : DANVILLE
State : IL
Zip : 61834-4509
Country : US
Telephone Number : 217-709-2494
Fax Number : 217-709-2344
Provider Business Practice Location Address
First Line : 140 ENTERPRISE DR
Second Line :
City : PITTSBURGH
State : PA
Zip : 15275-1213
Country : US
Telephone Number : 800-828-9194
Fax Number : 877-403-4196
Authorized Official
Title or Position : MANAGER
Name : JENNIFER PONCE
Credential :
Telephone Number : 847-527-2489
Provider Enumeration Date : 04/27/2023
Last Update Date : 02/03/2026

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1659513018 — WALGREENS SPECIALTY PHARMACY LLC
Practice Location Address:
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15275-1213
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Practice Fax: 877-231-8302
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1740566348 — MRS. KATHLEEN M KOKOSKI RPH
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1194158113 — MR. RUSSELL JUSTIN MCDOWELL PHARMD
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Practice Fax:
1871920967 — MR. MARK STEPHEN LAZUR RPH
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Practice Fax:
1639554132 — CATHERINE CIRRINCIONE
Practice Location Address:
130 ENTERPRISE DR
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Practice Fax:

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