NPIMap

Organization Active NPI

Kubat Pharmacy, LLC

  • Durable Medical Equipment & Medical Supplies
  • Norfolk, NE
National Provider Identifier
1538765920
Registry record updated Oct 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
KUBAT PHARMACY, LLC
Doing business as
Kubat HealthCare
Practice address
120 N 27TH St Ste 100a
Norfolk, NE 68701-3286
Phone
(402) 371-3444
Fax
(402) 371-3566
NPI assigned
Dec 10, 2020
Organization subpart
Yes
Parent organization
PERCIPIO RESPIRATORY HOLDCO, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 31, 2024

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

Authorized official

Name
Mr. Brian Paul Daniel
Title
Evp Medical Operations
Phone
(402) 301-1307

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

120 N 27TH St Ste 100a
Norfolk, NE 68701-3286

Mailing address

3206 S 71St St
Omaha, NE 68106-3507
Phone (402) 558-1192

Other names 1

  • Kubat HealthCare Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL BRIGHTREE Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210818001557 NE DME Supplier - Medical Supply Company With Respiratory TherapistDME Supplier - Oxygen & Equipment 5597883959 Practice locations: Norfolk, NE

Other NPIs with the same Medicare PAC ID 4

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

Laboratory certificates & supplier records

Derived by NPIMap

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

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Kubat Pharmacy LLC120 N 27TH St, Norfolk, NE 68701-3286(402) 371-3444 Tracheotomy Supplies|Urological Supplies|Continuous Positive Airway Pressure (CPAP) Devices|Mechanical In-Exsufflation Devices|Nebulizer Equipment and/or Supplies|Oxygen Equipment and/or Supplies|Respiratory Suction Pumps|Surgical Dressings Does not accept assignmentParticipating since Jan 1, 1998

National Provider Directory

National Provider Directory
Tax ID family
Kubat Pharmacy Inc8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Locations

120 N 27th St
Ste 100A
Norfolk, NE 68701
Phone (402) 371-3444

NPI Registry JSON

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

{
    "created_epoch": "1607558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730332800000",
    "number": "1538765920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3206 S 71ST ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681063507",
            "telephone_number": "402-558-1192",
            "fax_number": "402-558-0135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 N 27TH ST STE 100A",
            "city": "NORFOLK",
            "state": "NE",
            "postal_code": "687013286",
            "telephone_number": "402-371-3444",
            "fax_number": "402-371-3566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KUBAT PHARMACY, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PERCIPIO RESPIRATORY HOLDCO, LLC",
        "enumeration_date": "2020-12-10",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A",
        "authorized_official_last_name": "DANIEL",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "EVP MEDICAL OPERATIONS",
        "authorized_official_telephone_number": "402-301-1307",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "BRIGHTREE",
            "affiliation": "N",
            "endpointDescription": "SECURE 3RD PARTY SOFTWARE",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "NEHII",
            "address_1": "120 N 27th St Ste 200",
            "city": "Norfolk",
            "state": "NE",
            "country_code": "US",
            "postal_code": "687013286",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Kubat HealthCare",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Kubat HealthCare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Norfolk, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2024; 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.