WALGREENS SPECIALTY PHARMACY LLC (NPI# 1972847044) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972847044 |
| Entity Type | Organization |
| Organization Name | WALGREENS SPECIALTY PHARMACY LLC |
| Other Organization Name | WALGREEN SPECIALTY PHARMACY #12314 |
| Practice Address |
9775 Sw Gemini Dr Ste 1 Beaverton OR 97008 |
| Mailing Address |
1901 E Voorhees St Ms 790 Danville IL 61834-4509 |
| Practice Telephone | 5036438511 |
| Mailing Telephone | 2177092386 |
| Mailing Fax Number | 2177092344 |
| Enumeration Date | 2012-11-15 |
| Last Update Date | 2018-08-31 |
| Authorized Official Name | ALYSSA SWEETEN (MANAGER) |
| Authorized Official Telephone | 2177092386 |
| Is Organization Subpart | Y |
| Parent Organization Name | WALGREEN CO |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336S0011X |
Pharmacy Specialization: Specialty Pharmacy |
Suppliers |
| Other Name | Type Code |
|---|---|
| WALGREEN SPECIALTY PHARMACY #12314 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669668752 | Walgreens Specialty Pharmacy LLC | Pharmacy | 9775 Sw Gemini Dr, Ste 1, Beaverton, OR 97008 | 2007-09-21 |
| 1942303110 | Walgreens Specialty Pharmacy LLC | Pharmacy | 41460 Haggerty Cir S, Canton, MI 48188 | 2006-09-06 |
| 1679526974 | Walgreens Specialty Pharmacy LLC | Pharmacy | 412 Mount Kemble Ave, Suite 300n, Morristown, NJ 07960-6666 | 2006-05-18 |
| 1851695936 | Walgreens Specialty Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 104 Wilmot Rd, Msc 1435, Deerfield, IL 60015-5121 | 2011-01-04 |
| 1417284845 | Walgreens Specialty Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 41460 Haggerty Cir S, Canton, MI 48188-2227 | 2009-11-05 |
| 1659513018 | Walgreens Specialty Pharmacy LLC | Pharmacy | 130 Enterprise Dr, Pittsburgh, PA 15275-1213 | 2009-04-01 |
| 1417100751 | Walgreens Specialty Pharmacy LLC | Pharmacy | 412 Mount Kemble Ave, Suite 300n, Morristown, NJ 07960-6666 | 2008-10-30 |
| 1851463087 | Walgreens Specialty Pharmacy LLC | Pharmacy | 10530 John W Elliott Dr, Ste 100, Frisco, TX 75033 | 2006-11-14 |
| 1972560688 | Walgreens Specialty Pharmacy LLC | Pharmacy | 130 Enterprise Dr, Pittsburgh, PA 15275 | 2006-04-27 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Vermont Business Registrations | WALGREENS SPECIALTY PHARMACY LLC | 104 Wilmot Road, Deerfield, IL 60015 |
| Street Address |
9775 SW GEMINI DR STE 1 |
| City | BEAVERTON |
| State | OR |
| Zip Code | 97008 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760738330 | Lih-wern Wang | Pharmacist | 9775 Sw Gemini Dr Ste 1, Beaverton, OR 97008 | 2012-07-31 |
| 1821443987 | Huy Pham | Pharmacist | 9775 Sw Gemini Dr Ste 1, Beaverton, OR 97008-7148 | 2016-04-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972136638 | Kelly Mitchell | Counselor | 6600 Sw 105th Ave Suite 120, Beaverton, OR 97008 | 2020-02-20 |
| 1700305315 | Heather Denise Glenn | Counselor | 6700 Sw 105th Avenue, Suite 203, Beaverton, OR 97008 | 2017-09-14 |
| 1649798265 | Timothy Wilkins | Counselor | 8285 Sw Nimbus Ave #148, Beaverton, OR 97008 | 2017-09-04 |
| 1962920751 | West End Surgical, LLC | Clinic/Center | 9405 Sw Nimbus Ave, Beaverton, OR 97008 | 2017-09-01 |
| 1073054714 | University Professional Services | Durable Medical Equipment & Medical Supplies | 9317 Sw Nimbus Ave, Beaverton, OR 97008 | 2017-03-14 |
| 1508311424 | Mitra Gaspeed | Dental Hygienist | 8615 Sw Thoroughbred Pl., Beaverton, OR 97008 | 2016-08-20 |
| 1740521988 | Donna Louise Grenier | Registered Nurse | 1413 E St, Independence, OR 97008 | 2013-03-13 |
| 1508105735 | Mary Elizabeth Smith | Specialist/Technologist, Other | 11855sw Ridgecrest Dr, #209, Beaverton, OR 97008 | 2013-02-07 |
| 1629315551 | Adelfino J Zuriaga | Massage Therapist | 11985 Sw Camden Ln, Beaverton, OR 97008 | 2013-01-11 |
| 1578884912 | Michael Joseph Isaac | Dentist | 8660 Sw Scholls Ferry Road, Beaverton, OR 97008 | 2010-06-21 |
| Find all providers in zip 97008 | ||||
| Taxonomy Code | 3336S0011X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Specialty Pharmacy |
| A pharmacy that dispenses generally low volume and high cost medicinal preparations to patients who are undergoing intensive therapies for illnesses that are generally chronic, complex and potentially life threatening. Often these therapies require specialized delivery and administration. |
| 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: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396125399 | Credena Health LLC | Pharmacy | 6348 Ne Halsey St, Suite A, Portland, OR 97213-4720 | 2015-06-04 |
| 1528306081 | Rxmedlab Pharmacy, LLC | Pharmacy | 162 Ne Beacon Dr, Suite # 109, Grants Pass, OR 97526-4260 | 2013-01-17 |
| 1902975113 | Apria Healthcare, Inc. | Pharmacy | 12029 Ne Glenn Widing Dr, Portland, OR 97220-9050 | 2006-11-06 |
| 1649686999 | Kaiser Foundation Health Plan of The Northwest | Pharmacy | 3550 N Interstate Ave, Portland, OR 97227-1196 | 2014-07-08 |
| 1962832071 | Ardon Health, LLC | Pharmacy | 11835 Ne Glenn Widing Dr, Portland, OR 97220-9057 | 2013-11-26 |
| 1295901197 | Healthy Options Inc. | Pharmacy | 3500 Se 26th Ave, Portland, OR 97202-2901 | 2008-05-01 |
| 1790878965 | Oregon Health and Science University | Pharmacy | 3303 Sw Bond Ave, Portland, OR 97239-4501 | 2006-10-02 |
| 1922018639 | Peacehealth Medical Group | Pharmacy | 3333 Riverbend Dr, Springfield, OR 97477-8800 | 2006-08-08 |
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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.