ALLIANCERX WALGREENS PRIME #12314 (WALGREENS SPECIALTY PHARMACY LLC) NPI 1669668752

Pharmacy in Beaverton, OR

NPI 1669668752 Organization Pharmacy

About ALLIANCERX WALGREENS PRIME #12314 (WALGREENS SPECIALTY PHARMACY LLC)

Alliancerx Walgreens Prime #12314 (walgreens Specialty Pharmacy Llc) is a provider established in Beaverton, Oregon specializing in pharmacy. The NPI number of Alliancerx Walgreens Prime #12314 (walgreens Specialty Pharmacy Llc) is 1669668752 and was assigned on September 2007. The practitioner's primary taxonomy code is 333600000X with license number RP-0002419 (OR). The provider is registered as an organization and their NPI record was last updated one year ago. The provider's is doing business as Alliancerx Walgreens Prime #12314. The authorized official of this NPI record is Kira Taylor (Manager)

NPI

1669668752

Provider NameALLIANCERX WALGREENS PRIME #12314 (WALGREENS SPECIALTY PHARMACY LLC)
Provider Location Address9775 SW GEMINI DR STE 1 BEAVERTON, OR 97008
Provider Mailing Address1901 E VOORHEES ST MS 790 DANVILLE, IL 61834
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?Yes
Other Organization NameALLIANCERX WALGREENS PRIME #12314
Other Name TypeDoing Business As (3)
Enumeration Date09-21-2007
Last Update Date05-11-2021


Primary Taxonomy

Taxonomy Code333600000X
ClassificationPharmacy
TypeSuppliers
License No.RP-0002419
License StateOR
Taxonomy DescriptionA 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.

Business Address

ALLIANCERX WALGREENS PRIME #12314
9775 SW GEMINI DR
STE 1
BEAVERTON, OR
ZIP 97008
Phone: (866) 202-4014

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Mailing Address

ALLIANCERX WALGREENS PRIME #12314
1901 E VOORHEES ST
MS 790
DANVILLE, IL
ZIP 61834
Phone: (217) 709-2386
Fax: (217) 709-2344



Authorized Official

Authorized Official Name KIRA TAYLOR
Authorized Official TitleMANAGER
Authorized Official Phone(217) 709-2351

Secondary Taxonomies


The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.

No. Taxonomy Code Type Classification Specialization License No. State Primary
13336H0001XSuppliersPharmacyHome Infusion Therapy PharmacyNo

Taxonomy Description: pharmacy-based, decentralized patient care organization with expertise in USP 797-compliant sterile drug compounding that provides care to patients with acute or chronic conditions generally pertaining to parenteral administration of drugs, biologics and nutritional formulae administered through catheters and/or needles in home and alternate sites. Extensive professional pharmacy services, care coordination, infusion nursing services, supplies and equipment are provided to optimize efficacy and compliance.

23336S0011XSuppliersPharmacySpecialty PharmacyNo

Taxonomy Description: 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.

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
1669668752MEDICAID (05)ID
320618MEDICAID (05)AZ
3842944OTHER (01)
0216467MEDICAID (05)OH
1669668752MEDICAID (05)UT
1669668752MEDICAID (05)MT
1669668752MEDICAID (05)IA
3842944MEDICAID (05)TN
1092434MEDICAID (05)WA
1669668752MEDICAID (05)VA
200135400AMEDICAID (05)OK
37104811MEDICAID (05)NM
44039751MEDICAID (05)CO
457263MEDICAID (05)ND
1028445MEDICAID (05)AK
200923000AMEDICAID (05)IN
278926MEDICAID (05)OR
554205700MEDICAID (05)MD
1669668752MEDICAID (05)MI
1021135430001MEDICAID (05)PA
1669668752MEDICAID (05)MN
7100277090MEDICAID (05)KY
200333400EMEDICAID (05)KS
7R2419MEDICAID (05)SC
685274-01MEDICAID (05)HI

Other Providers at the same location


The following 11 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1346660990MR. CLAY PARKEL RPH
Individual
Pharmacist9775 SW GEMINI DR
BEAVERTON, OR 97008
(866) 202-4015
1275953879 ALAN KANNING RPH
Individual
Pharmacist9775 SW GEMINI DR
BEAVERTON, OR 97008
(866) 202-4015
1235559881MR. BRAD CRAIG BOEHME
Individual
Pharmacist9775 SW GEMINI DR STE 1
BEAVERTON, OR 97008
(866) 202-4014
1538589809 ELIZABETH ASAI
Individual
Pharmacist9775 SW GEMINI DR
BEAVERTON, OR 97008
(866) 202-4015
1164842597 SANDRA SCOTT
Individual
Pharmacist9775 SW GEMINI DR
BEAVERTON, OR 97008
(866) 202-4014
1053721084 SHARON OKABAYASHI BRANHAM
Individual
Pharmacist9775 SW GEMINI DR
BEAVERTON, OR 97008
(866) 202-4014
1588074520 SHERYL BLODGETT PHARMD
Individual
Pharmacist9775 SW GEMINI DR SUITE 1
BEAVERTON, OR 97008
(866) 202-4014
1720498371DR. NICOLE JEANE O'KANE PHARM.D.
Individual
Pharmacist9775 SW GEMINI DR STE 1
BEAVERTON, OR 97008
(866) 202-4014
1790196509 CHRIS FUEGY
Individual
Pharmacist9775 SW GEMINI DR
BEAVERTON, OR 97008
(866) 202-4014
1386897338 THERESA JAMES PHARMD
Individual
Pharmacist9775 SW GEMINI DR SUITE 1
BEAVERTON, OR 97008
(503) 520-6913
1477786788MRS. TRACY L FENTRESS R.PH.
Individual
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)9775 SW GEMINI DR
BEAVERTON, OR 97008
(888) 202-4014

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.