| NPI | 1790064533 | 
|---|---|
| Doing Business As | WALGREENS SPECIALTY PHARMACY #21393 | 
| Entity Type | Organization | 
| Authorized Contact | JENNIFER PONCE Manager 847-527-2489 | 
| Organization Subpart ? | Yes | 
| Primary Taxonomy | 333600000X Pharmacy (Licence: AZ Y005414) | 
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies | 
| 3336C0003X Pharmacy, Community/Retail Pharmacy | |
| Enumeration Date | 2011-08-10 | 
| Last Update Date | 2024-11-26 |