Individual provider Active NPI

Jerry Steve Rich, RPH

  • Pharmacist
  • Walla Walla, WA
National Provider Identifier
1790883619
Registry record updated Aug 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
10810 Issued in LA
Practice address
2415 Country Club Rd
Walla Walla, WA 99362-9261
Phone
(541) 580-5594
NPI assigned
Sep 21, 2006
Last updated
Aug 26, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 26570 FL
Pharmacist 183500000X 10810 LA Primary

Addresses

Primary practice location

2415 Country Club Rd
Walla Walla, WA 99362-9261

Mailing address

2415 Country Club Rd
Walla Walla, WA 99362-9261
Phone (541) 580-5594

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
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
26570FLMDPharmacist
10810LAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409011200000",
    "number": "1790883619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2415 COUNTRY CLUB RD",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993629261",
            "telephone_number": "541-580-5594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2415 COUNTRY CLUB RD",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993629261",
            "telephone_number": "541-580-5594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICH",
        "first_name": "JERRY",
        "middle_name": "STEVE",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2014-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "26570",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "LA",
            "license": "10810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walla Walla, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 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.