NPIMap

Organization Active NPI

Cammacks Pharmacies Inc

Doing business as Jims Pharmacy and Home Health

  • Community/Retail Pharmacy
  • Port Angeles, WA
National Provider Identifier
1548205776
Registry record updated Apr 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHARCF00057963 Issued in WA
Legal business name
CAMMACKS PHARMACIES INC
Doing business as
Jims Pharmacy and Home Health
Practice address
424 E 2ND St
Port Angeles, WA 98362-3119
Phone
(360) 452-4200
Fax
(360) 457-6557
NPI assigned
Jun 19, 2006
Last updated
Apr 9, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2020

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

Authorized official

Name
Joseph Cammack, RPHNPI 1932458940
Title
Owner
Phone
(360) 452-4200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X PHARCF00057963 WA Primary
Specialty Pharmacy 3336S0011X
Compounding Pharmacy 3336C0004X

Addresses

Primary practice location

424 E 2ND St
Port Angeles, WA 98362-3119

Mailing address

PO Box 220
Port Angeles, WA 98362-0035
Phone (360) 452-4200

Other identifiers 2

IdentifierTypeStateIssuer
6148704MedicaidWA
2108181OtherPK

Other names 1

  • JIMS PHARMACY AND HOME HEALTH Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040316000187 WA Part B Supplier - Pharmacy 2163312190 1 other NPI on this enrollment
Practice locations: Port Angeles, WA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1150675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586390400000",
    "number": "1548205776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 220",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983620035",
            "telephone_number": "360-452-4200",
            "fax_number": "360-457-6557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "424 E 2ND ST",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983623119",
            "telephone_number": "360-452-4200",
            "fax_number": "360-457-6557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMMACKS PHARMACIES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-19",
        "last_updated": "2020-04-09",
        "certification_date": "2020-04-09",
        "status": "A",
        "authorized_official_last_name": "CAMMACK",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-452-4200",
        "authorized_official_credential": "RPH"
    },
    "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": "PHARCF00057963",
            "primary": true
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6148704",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2108181",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JIMS PHARMACY AND HOME HEALTH",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "JIMS PHARMACY AND HOME HEALTH",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Port Angeles, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.