Kcje Ford Inc

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

Legal business name

KCJE FORD INC

Doing business as

MedPak Pharmacy

Practice address

505 King St Ste 154
La Crosse, WI 54601-4062

Phone

(608) 782-4448

Fax

(608) 782-4449

NPI assigned

Nov 30, 2009

Last updated

Aug 11, 2016By 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

Kristy Basseuner

Title

Pharmacy Technician

Phone

(608) 784-9922

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• MedPak Pharmacy Doing business as

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

{
    "created_epoch": "1259539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470873600000",
    "number": "1679801807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2496",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546022496",
            "telephone_number": "608-782-4448",
            "fax_number": "608-782-4449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 KING ST STE 154",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546014062",
            "telephone_number": "608-782-4448",
            "fax_number": "608-782-4449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KCJE FORD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-30",
        "last_updated": "2016-08-11",
        "status": "A",
        "authorized_official_last_name": "BASSEUNER",
        "authorized_official_first_name": "KRISTY",
        "authorized_official_title_or_position": "PHARMACY TECHNICIAN",
        "authorized_official_telephone_number": "608-784-9922"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "WI",
            "license": "9122-042",
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2122806",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100007292",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MedPak Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Barbara E Kaufmann, RD
• James R Kauphusman, MD
• Michitaka Kawata, M.D.
• Marc A Kayson, PH.D.
• Kcje Ford Inc (Cass Street Pharmacy)
• Edward Martin Keane, LPC
• Rebecca K Kearns, CNM
• Laura Jean Keatley, FNP-BC
• Hayden Kedrowski
• Rachel Keehner, PA-C

• Long Term Care Pharmacy in La Crosse, WI
• Providers in La Crosse, WI by specialty
• Long Term Care Pharmacy in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2016; 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.