WALGREENS SPECIALTY PHARMACY #15309 – NPI #1013280403
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.

WALGREENS SPECIALTY PHARMACY #15309 is a pharmacy located in MINNEAPOLIS, MN. NPPES has assigned the NPI number 1013280403 to WALGREENS SPECIALTY PHARMACY #15309 on February 15, 2012. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “WALGREENS SPECIALTY PHARMACY #15309” is a dba name, the actual legal business name for this organization is WALGREEN CO.. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 333600000X from the Health Care Provider Taxonomy code set, which is classified as Pharmacy.

The NPI profile was last updated on Nov 06, 2024. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for WALGREENS SPECIALTY PHARMACY #15309 below.

NPI Profile for
WALGREEN CO.

NPI Number
1013280403
Enumeration Date

(more than 14 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
WALGREEN CO.
Doing Business As (dba): WALGREENS SPECIALTY PHARMACY #15309
Primary location
2100 LYNDALE AVE S STE A
MINNEAPOLIS, MN 55405
Phone: (612) 872-7808 Fax: (612) 874-1084
Mailing address
1901 E VOORHEES ST
MS 790
DANVILLE, IL 61834-4509
Phone: (847) 527-2489 Fax: (217) 709-2344
Organization Subpart
Yes - WALGREENS SPECIALTY PHARMACY #15309 is subpart of another organization.
Authorized Official
JENNIFER PONCE
MANAGER
Phone: (847) 527-2489
Updated
Certification Date
Nov 06, 2024

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for WALGREENS SPECIALTY PHARMACY #15309

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
otherNCPDPMN2431271
medicaidIA1013280403
medicaidSD1013280403
medicaidWI1013280403
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
333600000X
- Pharmacy (Primary)
MN 263842
3336C0003X
- Pharmacy / Community/Retail Pharmacy
332B00000X
- Durable Medical Equipment & Medical Supplies

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.