KJK LLC
Organization Active NPI Community/Retail Pharmacy · Fairview, TN
NPI 1730680414 · NPPES record last updated Oct 27, 2025
Key facts
- NPI
- 1730680414
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- Legal business name
- KJK LLC
- Practice address
- 2340 Fairview Blvd. Suite 300
Fairview, TN 37062 - Phone
- (615) 446-8043
- Fax
- (615) 446-7556
- NPI assigned
- Feb 27, 2018
- Organization subpart
- No
Authorized official
- Name
- Christopher Paul Konecny
- Title
- Cfo, Owner, Pharmd
- Phone
- (732) 580-5805
Corporate family (same tax ID) 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20191022001825 | TN | Part B Supplier - Mass Immunization (Roster Biller Only) | 9931431012 | Practice locations: Fairview, TN |
National Provider Directory
- Tax ID family
- Church Street Pharmacy
Locations
2340 Fairview Blvd
Ste 300
Fairview, TN 37062
Phone (615) 387-9000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | Yes |
Addresses
Primary practice location
2340 Fairview Blvd. Suite 300
Fairview, TN 37062
Mailing address
2340 Fairview Blvd. Suite 300
Fairview, TN 37062
Phone (615) 387-9000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Q072310001 | Medicaid | TN | |
| Q045582 | Medicaid | TN |
Other names
- Goodlark Pharmacy at Fairview
Other providers in Fairview, TN
- Sherry J Kelly
- Key Chiropractic PLLC
- Alan Killingsworth
- King Family Dental PLLC
- Caleb Timothy King
- Nicholas Kramer
- Devin Kye Krekel
- Allison Leich Hilbun
- Paul Frank Luther Jr.
- Lesley Marie Mathis
All providers in Fairview, TN · Community/Retail Pharmacy in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 27, 2025. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.