Walmart Pharmacy

Primary specialty

PharmacistTaxonomy code 183500000X

License

PH60132714 Issued in WA

Legal business name

WALMART PHARMACY

Practice address

21200 Olhava Way NW
Poulsbo, WA 98370-9457

Phone

(360) 697-2091

NPI assigned

Nov 8, 2014

Organization subpart

No

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

Authorized official

Name

Katherine Ibrahim

Title

Pharmacist

Phone

(360) 697-2091

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1415404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415404800000",
    "number": "1477959088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21200 OLHAVA WAY NW",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983709457",
            "telephone_number": "360-697-2091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21200 OLHAVA WAY NW",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983709457",
            "telephone_number": "360-697-2091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALMART PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-08",
        "last_updated": "2014-11-08",
        "status": "A",
        "authorized_official_last_name": "IBRAHIM",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "360-697-2091"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH60132714",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blake Joseph Wagner, D.C.
• Wal-Mart Stores, Inc
• Robert Livingston Walker, LMHC
• Kristin Waller, RPH
• Walmart Inc.
• Wandee J. Pryor, Psy.D., LLC
• Katerina Warns
• Washington CVS Pharmacy LLC
• Tessa C Watson, LMT
• Kelly Watt, LICSW

• Pharmacist in Poulsbo, WA
• Providers in Poulsbo, WA by specialty
• Pharmacist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2014; 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.