Individual provider Active NPI

Walter Gerard Jalowiecz, RPH

  • Pharmacist
  • Lowell, MI
National Provider Identifier
1215218243
Registry record updated Sep 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5302025980 Issued in MI
Practice address
11980 Fulton St E
Lowell, MI 49331-9428
Phone
(616) 897-3160
NPI assigned
Sep 3, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5302025980 MI Primary

Addresses

Primary practice location

11980 Fulton St E
Lowell, MI 49331-9428

Mailing address

5289 Silverstone Dr NE
Comstock Park, MI 49321-8269
Phone (616) 647-9122

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
5302025980MIMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co Past Accepting new patients
Walgreen Co PastSince Apr 10, 2022 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1315008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315008000000",
    "number": "1215218243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5289 SILVERSTONE DR NE",
            "city": "COMSTOCK PARK",
            "state": "MI",
            "postal_code": "493218269",
            "telephone_number": "616-647-9122",
            "fax_number": "616-647-9058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11980 FULTON ST E",
            "city": "LOWELL",
            "state": "MI",
            "postal_code": "493319428",
            "telephone_number": "616-897-3160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JALOWIECZ",
        "first_name": "WALTER",
        "middle_name": "GERARD",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-03",
        "last_updated": "2011-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302025980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lowell, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2011; 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.