Active NPI
Jollys Pharmacy Inc
- Long Term Care Pharmacy
- Renton, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Long Term Care Pharmacy
- License
- PHAR.CF.60065440
- Legal business name
- JOLLYS PHARMACY INC
- Doing business as
- Ready Meds Pharmacy
- Practice address
- 1412 SW 43Rd St
Suite 120
Renton, WA 98057-4803 - Phone
- (425) 251-6335
- Fax
- (425) 251-6337
- NPI assigned
- Sep 11, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Anderson S. Jolly, BS C PHARM
- Title
- Owner
- Phone
- (425) 251-6335
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Long Term Care Pharmacy | 3336L0003X | PHAR.CF.60065440 | WA | Primary |
Addresses
Primary practice location
1412 SW 43Rd St
Suite 120
Renton, WA 98057-4803
Mailing address
1412 SW 43Rd St Ste 120
Renton, WA 98057-4803
Phone (425) 251-6335
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2007021 | Medicaid | WA |
Other names 1
- Ready Meds Pharmacy
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120103000687 | WA | DME Supplier - Pharmacy | 4981870581 | Practice locations: Renton, WA |
| O20120716000602 | WA | Part B Supplier - Mass Immunization (Roster Biller Only) | 4981870581 | Practice locations: Renton, WA |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Jollys Pharmacy | Epoetin|Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order)|Blood Glucose Monitors/Supplies (Mail Order) | Accepts assignment |
National Provider Directory
National Provider DirectoryLocations
1412 SW 43rd St
#120B
Renton, WA 98057
Phone (425) 251-6335
1412 SW 43rd St
Ste 120B
Renton, WA 98057
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pharmacist
- Renton, WA
- NPI 1245353234
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1221091200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1505260800000",
"number": "1235388430",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1412 SW 43RD ST STE 120",
"city": "RENTON",
"state": "WA",
"postal_code": "980574803",
"telephone_number": "425-251-6335",
"fax_number": "425-251-6337"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1412 SW 43RD ST",
"address_2": "SUITE 120",
"city": "RENTON",
"state": "WA",
"postal_code": "980574803",
"telephone_number": "425-251-6335",
"fax_number": "425-251-6337"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "JOLLYS PHARMACY INC",
"organizational_subpart": "NO",
"enumeration_date": "2008-09-11",
"last_updated": "2017-09-13",
"status": "A",
"authorized_official_last_name": "JOLLY",
"authorized_official_first_name": "ANDERSON",
"authorized_official_middle_name": "S.",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "425-251-6335",
"authorized_official_credential": "BS C PHARM"
},
"taxonomies": [
{
"code": "3336L0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Long Term Care Pharmacy",
"state": "WA",
"license": "PHAR.CF.60065440",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2007021",
"state": "WA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Ready Meds Pharmacy",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Renton, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.