Jkrxllc

Primary specialty

Compounding PharmacyTaxonomy code 3336C0004X

Legal business name

JKRXLLC

Doing business as

j kohll RX

Practice address

13110 W Dodge Rd Ste B
Omaha, NE 68154-2102

Phone

(402) 408-0015

Fax

(402) 408-0020

NPI assigned

Dec 31, 2019

Last updated

Dec 31, 2019By 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

Justin M Kohll, R.PH

Title

President

Phone

(402) 306-6503

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• j kohll RX Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NE

Enrollment records 1

Locations

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

{
    "created_epoch": "1577750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1577750400000",
    "number": "1386283893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16705 ONTARIO PLZ",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681302131",
            "telephone_number": "402-306-6503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13110 W DODGE RD STE B",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681542102",
            "telephone_number": "402-408-0015",
            "fax_number": "402-408-0020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "620 N 114th St",
            "address_purpose": "LOCATION",
            "city": "Omaha",
            "state": "NE",
            "postal_code": "681541571",
            "country_code": "US",
            "telephone_number": "402-306-6503",
            "fax_number": "402-408-0015",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JKRXLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-31",
        "last_updated": "2019-12-31",
        "certification_date": "2019-12-31",
        "status": "A",
        "authorized_official_last_name": "KOHLL",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "402-306-6503",
        "authorized_official_credential": "R.PH"
    },
    "taxonomies": [
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CASH ONLY",
            "identifier": "762",
            "state": "NE"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Omaha",
            "affiliation": "N",
            "endpointDescription": "pharmacy",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "620 N 114th St",
            "city": "Omaha",
            "state": "NE",
            "country_code": "US",
            "postal_code": "681541571",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "j kohll RX",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Compounding Pharmacy in Omaha, NE
• Providers in Omaha, NE by specialty
• Compounding Pharmacy in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2019; 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.