NPIMap

Organization Active NPI

Sakrx, LLC

  • Durable Medical Equipment & Medical Supplies
  • Malvern, IA
National Provider Identifier
1154896199
Registry record updated Apr 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
SAKRX, LLC
Practice address
403 Main St
Malvern, IA 51551-8137
Phone
(712) 624-9036
NPI assigned
Oct 5, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2025

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

Authorized official

Name
Mr. Peter E Jensen
Title
Cfo
Phone
(402) 973-1915

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

403 Main St
Malvern, IA 51551-8137

Mailing address

12741 Q St
Omaha, NE 68137-3211
Phone (402) 895-6812

Other names 1

  • Kohll's RX Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20190305001241 IA DME Supplier - PharmacyDME Supplier - Medical Supply Company With Orthotic-Prosthetic 4789934878 Practice locations: Malvern, IA
O20190503000577 IA Part B Supplier - Mass Immunization (Roster Biller Only) 4789934878 Practice locations: Malvern, IA

Other NPIs with the same Medicare PAC ID 8

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Sakrx LLC14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

Organizations that report the same tax identification number in the National Provider Directory.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1538697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743465600000",
    "number": "1154896199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12741 Q ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681373211",
            "telephone_number": "402-895-6812",
            "fax_number": "402-895-7655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 MAIN ST",
            "city": "MALVERN",
            "state": "IA",
            "postal_code": "515518137",
            "telephone_number": "712-624-9036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAKRX, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-05",
        "last_updated": "2025-04-01",
        "certification_date": "2025-04-01",
        "status": "A",
        "authorized_official_last_name": "JENSEN",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "402-973-1915",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kohll's RX",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Kohll's RX",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Malvern, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.