K2Red LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

17019RP Issued in ID

Legal business name

K2RED LLC

Doing business as

Jerome Drug

Practice address

111 Pioneer CT Ste 2
Jerome, ID 83338-5193

Phone

(208) 324-2440

Fax

(208) 324-2165

NPI assigned

Jul 7, 2011

Last updated

Mar 29, 2016By 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

Daniel Fuchs, RPH

Title

Member/RPH

Phone

(208) 735-8700

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Jerome Drug Doing business as

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• K2Red L.L.C.

  dba Dick's Pharmacy

  • Community/Retail Pharmacy
  • Twin Falls, ID
  • NPI 1295832574

  O20140325001579

  Same enrollment
• K2Red LLC

  dba Buhl Drug

  • Community/Retail Pharmacy
  • Buhl, ID
  • NPI 1083928832

  O20140325001579

  Same enrollment
• K2Red LLC

  • Community/Retail Pharmacy
  • Wendell, ID
  • NPI 1508420373

  O20140325001579

  Same enrollment

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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.

• Devon Hope

  • Pharmacist
  • Jerome, ID
  • NPI 1275010092
  NPD (past)

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

{
    "created_epoch": "1309996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459209600000",
    "number": "1073800314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 PIONEER CT STE 2",
            "city": "JEROME",
            "state": "ID",
            "postal_code": "833385193",
            "telephone_number": "208-324-2440",
            "fax_number": "208-324-2165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 PIONEER CT STE 2",
            "city": "JEROME",
            "state": "ID",
            "postal_code": "833385193",
            "telephone_number": "208-324-2440",
            "fax_number": "208-324-2165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "K2RED LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-07",
        "last_updated": "2016-03-29",
        "status": "A",
        "authorized_official_last_name": "FUCHS",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "MEMBER/RPH",
        "authorized_official_telephone_number": "208-735-8700",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "ID",
            "license": "17019RP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2130826",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jerome Drug",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Johnson Chiropractic Clinic
• Laura Marie Johnson Stevenson, BS DC CCEP
• Brian Lee Johnson, M.D.
• Elizabeth Jo Johnson, M.D.
• Logan Reed Jones, DO
• Mark Keele, DO
• Michael J Keller, DO
• Joshua William Kern, M.D.
• Samuel Keys
• Brianna Lynn Kober, MS, BCBA

• Community/Retail Pharmacy in Jerome, ID
• Providers in Jerome, ID by specialty
• Community/Retail Pharmacy in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.