NPIMap

Organization Active NPI

JRK Pharma Inc

  • Community/Retail Pharmacy
  • Edmonds, WA
National Provider Identifier
1063714434
Registry record updated May 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHARCF60180646 Issued in WA
Legal business name
JRK PHARMA INC
Doing business as
Edmonds Pharmacy @ Stevens Health Center
Practice address
21701 76TH Ave W Ste 104a
Edmonds, WA 98026-7536
Phone
(425) 563-6381
Fax
(425) 563-6385
NPI assigned
Nov 17, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 27, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Saikrishna Arumilli
Title
Owner
Phone
(425) 563-6381

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X PHARCF60180646 WA Primary
Compounding Pharmacy 3336C0004X
Mail Order Pharmacy 3336M0002X
Managed Care Organization Pharmacy 3336M0003X
Specialty Pharmacy 3336S0011X

Addresses

Primary practice location

21701 76TH Ave W Ste 104a
Edmonds, WA 98026-7536

Mailing address

21701 76TH Ave W Ste 104a
Edmonds, WA 98026-7536
Phone (425) 563-6381

Other identifiers 2

IdentifierTypeStateIssuer
2015087MedicaidWA
2127034OtherPK

Other names 1

  • Edmonds Pharmacy @ Stevens Health Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Edmonds Pharmacy Stevens Health Center4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

21701 76th Ave W
Ste 104A
Edmonds, WA 98026
Phone (425) 563-6381

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1289952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464307200000",
    "number": "1063714434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21701 76TH AVE W STE 104A",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980267536",
            "telephone_number": "425-563-6381",
            "fax_number": "425-563-6385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21701 76TH AVE W STE 104A",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980267536",
            "telephone_number": "425-563-6381",
            "fax_number": "425-563-6385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JRK PHARMA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-17",
        "last_updated": "2016-05-27",
        "status": "A",
        "authorized_official_last_name": "ARUMILLI",
        "authorized_official_first_name": "SAIKRISHNA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "425-563-6381"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WA",
            "license": "PHARCF60180646",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336M0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Mail Order Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336M0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Managed Care Organization Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2015087",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2127034",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Edmonds Pharmacy @ Stevens Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Edmonds, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.