WALGREEN SPECIALTY PHARMACY LLC (NPI# 1225339971) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225339971 |
| Entity Type | Organization |
| Organization Name | WALGREEN SPECIALTY PHARMACY LLC |
| Other Organization Name | WALGREEN SPECIALTY PHARMACY #12201 |
| Practice Address |
1143 Highland Dr Suite D Ann Arbor MI 48108-2237 |
| Mailing Address |
1901 E Voorhees St Ms 790 Danville IL 61834-4509 |
| Practice Telephone | 8882825166 |
| Mailing Telephone | 2177092386 |
| Mailing Fax Number | 2177092344 |
| Enumeration Date | 2010-11-11 |
| Last Update Date | 2011-01-20 |
| Authorized Official Name | MR. KERMIT R CRAWFORD (SR CORPORATE VICE PRESIDENT) |
| Authorized Official Telephone | 8479143154 |
| Is Organization Subpart | Y |
| Parent Organization Name | WALGREEN CO |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336S0011X |
Pharmacy Specialization: Specialty Pharmacy |
Suppliers | ||
| Y | 333600000X | Pharmacy | Suppliers |
| Other Name | Type Code |
|---|---|
| WALGREEN SPECIALTY PHARMACY #12201 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467909580 | Walgreen Specialty Pharmacy LLC | Pharmacy | 8325 S Park Cir, Ste 200, Orlando, FL 32819-9075 | 2016-09-07 |
| Street Address |
1143 HIGHLAND DR SUITE D |
| City | ANN ARBOR |
| State | MI |
| Zip Code | 48108-2237 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497056147 | Walgreens Specialty Pharmacy, LLC | Pharmacy | 1143 Highland Dr, Suite D, Ann Arbor, MI 48108-2234 | 2010-11-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750999249 | Creating Brighter Futures | Behavioral Analyst | 4201 Varsity Drive, Ste. C, Ann Arbor, MI 48108 | 2020-07-21 |
| 1326506320 | Michelle Bishop | Behavior Technician | 4935 Birch Hollow Dr, Ann Arbor, MI 48108 | 2019-03-08 |
| 1407326077 | Alexis Ewald | Behavior Technician | 2770 Carpenter Rd., Ann Arbor, MI 48108 | 2018-11-27 |
| 1003308511 | Ann Arbor Dental Specialists | Dentist | 3100 Eisenhower Parkway, Suite 200, Ann Arbor, MI 48108 | 2018-05-31 |
| 1144719295 | Jonathan Parker Etter | Physical Medicine & Rehabilitation | 325 E. Eisenhower, Suite 300, Spc 5744, Ann Arbor, MI 48108 | 2018-05-04 |
| 1427555895 | Blossom Health Services LLC | Social Worker | 2156 Glencoe Hills Dr Apt 12, Ann Arbor, MI 48108 | 2018-04-11 |
| 1669974580 | Camron Anthony Moorehead | Occupational Therapist | 400 E. Eisenhower Parkway Bldg 2, Ste A, Ann Arbor, MI 48108 | 2018-03-07 |
| 1396247862 | Crystal Ann D'agostino | Health Educator | 1169 Oak Valley Drive, Ann Arbor, MI 48108 | 2018-03-01 |
| 1538671250 | Miea Moon | Psychologist | 3200 E Eisenhower Parkway, Moriah Hall, Ann Arbor, MI 48108 | 2017-11-03 |
| 1003355546 | Rachael Connolly | Behavior Technician | 4201 Varsity Drive Suite C, Ann Arbor, MI 48108 | 2017-02-16 |
| Find all providers in zip 48108 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | 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. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386164440 | Manoj Rathi | Pharmacy | 201 S 1st St Apt 712, Ann Arbor, MI 48104-1395 | 2017-06-20 |
| 1255787610 | Healthplus Pharmacy of Ann Arbor Inc | Pharmacy | 4350 Jackson Rd Ste 250, Ann Arbor, MI 48103-1890 | 2016-05-04 |
| 1003967035 | Regents of The University of Michigan | Pharmacy | 1500 E Medical Center Dr Spc 5008, Spc 5008, Ann Arbor, MI 48109-5008 | 2007-01-16 |
| 1922019561 | Cascade Hemophilia Consortium | Pharmacy | 517 W William St, Ann Arbor, MI 48103-4943 | 2006-08-10 |
| 1457382434 | Kmart of Michigan Inc | Pharmacy | 215 N Maple Rd, Ann Arbor, MI 48103-2823 | 2006-07-06 |
| 1255801148 | Michigan Urgent Care | Pharmacy | 3280 Washtenaw Ave, Ann Arbor, MI 48104-4250 | 2018-12-04 |
| 1639424385 | Sasco Village LLC | Pharmacy | 325 N Maple Rd, Ann Arbor, MI 48103-2824 | 2012-07-18 |
| 1619291788 | University of Michigan Health System | Pharmacy | 1500 E Medical Center Dr, B1-282 Cancer Center, Ann Arbor, MI 48109-5000 | 2010-03-18 |
| 1518116789 | Regents of The University of Michigan Ambulatory Pharmacy | Pharmacy | 4260 Plymouth Rd, Room 1002, Ann Arbor, MI 48109-2700 | 2008-09-12 |
| 1033385851 | Regents of The University of Michigan Ambulatory Pharmacy | Pharmacy | 1500 E Medical Center Dr, Umh Ambulatory Pharmacy Services, Ann Arbor, MI 48109-5000 | 2008-05-01 |
| Find all providers in ANN ARBOR | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.