Jimmie Carl Baker, PHARMACIST
Individual provider Active NPI Pharmacist · Childress, TX
NPI 1558910281 · NPPES record last updated Sep 5, 2019
Key facts
- NPI
- 1558910281
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 23020 (TX)
- Practice address
- 2801 Avenue F NW
Childress, TX 79201-2229 - Phone
- (940) 937-6168
- NPI assigned
- Sep 5, 2019
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23020 | TX | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wal-Mart Stores Texas LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 23020 | TX | Yes |
Addresses
Primary practice location
2801 Avenue F NW
Childress, TX 79201-2229
Mailing address
1003 S Houston St
Shamrock, TX 79079-2805
Phone (806) 334-1652
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | Pharmacy | Health Information Exchange (HIE) |
Other providers in Childress, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 5, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.