Active NPI
Jamilah Walls
- Pharmacist
- Eastpointe, MI
National Provider Identifier
1679295026
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302414555
- Practice address
- 24765 Mabray Ave
Eastpointe, MI 48021-1433 - Phone
- (313) 510-7420
- NPI assigned
- Sep 13, 2022
- Last updated
- Sep 13, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5302414555 | MI | Primary |
Addresses
Primary practice location
24765 Mabray Ave
Eastpointe, MI 48021-1433
Mailing address
24765 Mabray Ave
Eastpointe, MI 48021-1433
Phone (313) 510-7420
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5302414555 | MI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1663027200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1663027200000",
"number": "1679295026",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24765 MABRAY AVE",
"city": "EASTPOINTE",
"state": "MI",
"postal_code": "480211433",
"telephone_number": "313-510-7420"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24765 MABRAY AVE",
"city": "EASTPOINTE",
"state": "MI",
"postal_code": "480211433",
"telephone_number": "313-510-7420"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALLS",
"first_name": "JAMILAH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-09-13",
"last_updated": "2022-09-13",
"certification_date": "2022-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302414555",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eastpointe, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.