Kcklg LLC

Primary specialty

Specialty PharmacyTaxonomy code 3336S0011X

Legal business name

KCKLG LLC

Doing business as

Bliss Pharmacy

Practice address

6496 Medical Center St Ste 101
Las Vegas, NV 89148-2409

Phone

(702) 749-7404

Fax

(702) 749-7414

NPI assigned

Sep 18, 2019

Organization subpart

No

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

Authorized official

Name

Laylani Macaraeg

Title

Owner

Phone

(702) 374-7344

Specialties & licenses 3

Addresses

Other names 1

• Bliss Pharmacy Doing business as

Locations

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

{
    "created_epoch": "1568764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592352000000",
    "number": "1124678453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6496 MEDICAL CENTER ST STE 101",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891482409",
            "telephone_number": "702-749-7404",
            "fax_number": "702-749-7414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6496 MEDICAL CENTER ST STE 101",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891482409",
            "telephone_number": "702-749-7404",
            "fax_number": "702-749-7414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KCKLG LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-18",
        "last_updated": "2020-06-17",
        "certification_date": "2020-06-17",
        "status": "A",
        "authorized_official_last_name": "MACARAEG",
        "authorized_official_first_name": "LAYLANI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-374-7344"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bliss Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bliss Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Specialty Pharmacy in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Specialty Pharmacy in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2020; 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.