Kirk'S Drug, Inc

Primary specialty

Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X

Legal business name

KIRK'S DRUG, INC

Practice address

6906 Martin Way
Olympia, WA 98516-5567

Phone

(360) 456-5475

Fax

(360) 491-2161

NPI assigned

May 23, 2005

Organization subpart

Yes

Parent organization

KIRK'S DRUG, INCAs reported in NPPES

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

Authorized official

Name

Marvin James Waletich, RPHNPI 1376289116

Title

Ceo

Phone

(360) 694-7377

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Kirk's CHS Medical Services Doing business as

Tax ID family

Kirks Drug Inc2 organizations share this tax ID, including this one

Part of

Kirks Drug Inc

Other organizations with this tax ID 1

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

• Kirks Drug Inc

  • Clinic Pharmacy
  • Lacey, WA
  • NPI 1598903940
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Marvin James Waletich, RPH

  • Pharmacist
  • Castle Rock, WA
  • NPI 1376289116
  NPD Authorized official

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

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282176000000",
    "number": "1215930300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6149 MARTIN WAY E",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985165547",
            "telephone_number": "360-493-8614",
            "fax_number": "360-493-8612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6906 MARTIN WAY",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985165567",
            "telephone_number": "360-456-5475",
            "fax_number": "360-491-2161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIRK'S DRUG, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KIRK'S DRUG, INC",
        "enumeration_date": "2005-05-23",
        "last_updated": "2010-08-19",
        "status": "A",
        "authorized_official_last_name": "WALETICH",
        "authorized_official_first_name": "MARVIN",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "360-694-7377",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "WA",
            "license": null,
            "primary": false
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1005114",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9011800",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kirk's CHS Medical Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kirby Healthcare, LLC
• Rindi Rachelle Kirby-Dodge
• Alexis Marie Kirilovets, LPN
• Arthur Kirk
• Lisa C Kirk, LMP
• Deborah Kirkpatrick, DOULA, MIDWIFE
• Stephen Lee Kirkpatrick, D.D.S.
• Jodi R Kirkwood
• Karen Harriett Kirsch, CMA, RSMT
• Daniel James Kissau, MD

• Oxygen Equipment & Supplies (DME) in Olympia, WA
• Providers in Olympia, WA by specialty
• Oxygen Equipment & Supplies (DME) in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2010; 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.