GKB Inc.
Organization Active NPI Community/Retail Pharmacy · Jefferson, NC
NPI 1619987385 · NPPES record last updated Nov 15, 2007
Key facts
- NPI
- 1619987385
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- 5064 (NC)
- Legal business name
- GKB INC.
- Practice address
- 418 E Main St
Jefferson, NC 28640-0155 - Phone
- (336) 246-9492
- Fax
- (336) 846-9177
- NPI assigned
- Aug 8, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Greg Keith Bower, RPH
- Title
- Owner
- Phone
- (336) 246-9492
Corporate family (same tax ID) 1
Practitioners 1
Laboratory certificates & supplier records
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| GKB Inc |
Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Canes and/or Crutches|Walkers|Ostomy Supplies|Urological Supplies|Nebulizer Equipment and/or Supplies | Does not accept assignment |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in NC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930061103 | NC | DME Supplier - Pharmacy | 5597883314 | Practice locations: Jefferson, NC |
| O20160209001945 | NC | Part B Supplier - Mass Immunization (Roster Biller Only) | 5597883314 | Practice locations: Jefferson, NC |
National Provider Directory
- Tax ID family
- GKB Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | 5064 | NC | Yes |
Addresses
Primary practice location
418 E Main St
Jefferson, NC 28640-0155
Mailing address
PO Box 155
418 E Main St
Jefferson, NC 28640-0155
Phone (336) 246-9492
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7700417 | Medicaid | NC |
Other names
- JEFFERSON DRUG STORE
Other providers in Jefferson, NC
- Marilyn Martin Gamewell
- Amanda Elizabeth Gentry
- Beverly Lynn Gilley
- Amanda Kayanna Gilligan
- GKB Inc
- Robert S Grajewski
- Kathryn L Green
- Joyce Greene
- Halo Center of Wellness, PA
- Rachel Hamby
All providers in Jefferson, NC · Community/Retail Pharmacy in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 15, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.