NPIMap

Organization Active NPI

CJK Pharmacy, LLC

  • Long Term Care Pharmacy
  • Cedar Rapids, IA
National Provider Identifier
1164064093
Registry record updated Oct 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
CJK PHARMACY, LLC
Practice address
3100 E Ave NW Ste 102
Cedar Rapids, IA 52405-2962
Phone
(319) 200-1188
Fax
(319) 200-1003
NPI assigned
Oct 11, 2019
Organization subpart
Yes
Parent organization
CJK PHARMACY, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 11, 2019

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

Authorized official

Name
Kimberly Vanschepen
Title
Pharmacist/Owner
Phone
(319) 200-1188

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X Primary

Addresses

Primary practice location

3100 E Ave NW Ste 102
Cedar Rapids, IA 52405-2962

Mailing address

3100 E Ave NW Ste 102
Cedar Rapids, IA 52405-2962
Phone (319) 200-1188

Other identifiers 1

IdentifierTypeStateIssuer
0713135MedicaidIA

Other names 1

  • CR Care Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
CJK Pharmacy LLC2 organizations share this tax ID, including this one
Part of
CJK Pharmacy LLC

Other organizations with this tax ID 1

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1570752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1570752000000",
    "number": "1164064093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 E AVE NW STE 102",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524052962",
            "telephone_number": "319-200-1188",
            "fax_number": "319-200-1003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 E AVE NW STE 102",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524052962",
            "telephone_number": "319-200-1188",
            "fax_number": "319-200-1003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CJK PHARMACY, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CJK PHARMACY, LLC",
        "enumeration_date": "2019-10-11",
        "last_updated": "2019-10-11",
        "status": "A",
        "authorized_official_last_name": "VANSCHEPEN",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "PHARMACIST/OWNER",
        "authorized_official_telephone_number": "319-200-1188"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0713135",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CR Care Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cedar Rapids, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2019; 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.