Kirks Drug Inc

Primary specialty

Clinic PharmacyTaxonomy code 3336C0002X

License

60062942 Issued in WA

Legal business name

KIRKS DRUG INC

Doing business as

Kirks at BHR

Practice address

4422 6TH Ave SE
Lacey, WA 98503-1020

Phone

(360) 456-2030

Fax

(360) 456-2318

NPI assigned

Jan 22, 2009

Last updated

Feb 18, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jim Rodgers

Title

General Manager

Phone

(360) 456-5475

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Kirks at BHR Doing business as

Tax ID family

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

Other organizations with this tax ID 1

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

• Kirk's Drug, Inc

  dba Kirk's CHS Medical Services

  • Oxygen Equipment & Supplies (DME)
  • Olympia, WA
  • NPI 1215930300
  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, and the practitioner matching its NPPES authorized official.

• Marvin James Waletich, RPH

  • Pharmacist
  • Castle Rock, WA
  • NPI 1376289116
  NPD

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

{
    "created_epoch": "1232582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234915200000",
    "number": "1598903940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4422 6TH AVE SE",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985031020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4422 6TH AVE SE",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985031020",
            "telephone_number": "360-456-2030",
            "fax_number": "360-456-2318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIRKS DRUG INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-22",
        "last_updated": "2009-02-18",
        "status": "A",
        "authorized_official_last_name": "RODGERS",
        "authorized_official_first_name": "JIM",
        "authorized_official_title_or_position": "GENERAL MANAGER",
        "authorized_official_telephone_number": "360-456-5475"
    },
    "taxonomies": [
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "WA",
            "license": "60062942",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6016646",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "4933164",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kirks at BHR",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• James Austin King
• Julie Tamar Kinn, PH.D.
• Sarah M Kinnard, ARNP
• Esther Wanjiru Kinyanjui
• Deborah L Kirby, CPC
• Teonna Monique Kirkwood
• Aphton Marie Kirschbaum, LMP
• Gavin David Kisebach
• Brenda L Kittrell, LMSW, ACSW, MAC
• Klein Chiropractic P C

• Clinic Pharmacy in Lacey, WA
• Providers in Lacey, WA by specialty
• Clinic Pharmacy in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2009; 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.