Update this page – If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS.
Organization
WALMART
Active
Organization
WALMART
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICAJAH JENKINS (PHARMACIST)
(253) 509-2176
Entity
Organization
Contact information
Practice address
3497 BETHEL RD SE, PORT ORCHARD, WA 98366-5634
(360) 874-9063
(360) 874-0071
Mailing address
6690 REGENCY DR SE, NONE, PORT ORCHARD, WA 98367-9514
(253) 509-2176
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PH60031151
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PH60031151
PHARMACIST LICENSE
WA
Enumeration date
08/14/2014
Last updated
08/14/2014
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up