Kcjse Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

004493 Issued in MO

Legal business name

KCJSE INC

Doing business as

THE DRUG STORE

Practice address

610 N Walnut St
Cameron, MO 64429-1831

Phone

(816) 632-7211

Fax

(816) 632-3645

NPI assigned

Sep 12, 2005

Organization subpart

No

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

Authorized official

Name

JS Erickson, PHARMACY

Title

Ceo

Phone

(816) 632-7211

Specialties & licenses 3

Addresses

Other identifiers 3

Other names 1

• THE DRUG STORE Doing business as

Locations

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

{
    "created_epoch": "1126483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1588118400000",
    "number": "1821083312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 N WALNUT ST",
            "city": "CAMERON",
            "state": "MO",
            "postal_code": "644291831",
            "telephone_number": "816-632-7211",
            "fax_number": "816-632-3645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 N WALNUT ST",
            "city": "CAMERON",
            "state": "MO",
            "postal_code": "644291831",
            "telephone_number": "816-632-7211",
            "fax_number": "816-632-3645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KCJSE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-12",
        "last_updated": "2020-04-29",
        "certification_date": "2020-04-29",
        "status": "A",
        "authorized_official_last_name": "ERICKSON",
        "authorized_official_first_name": "JS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "816-632-7211",
        "authorized_official_credential": "PHARMACY"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MO",
            "license": "004493",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "600280101",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "620028100",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2049743",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "THE DRUG STORE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "THE DRUG STORE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Dwight C Jackson II
• Marcus Scott Juracek, DC
• Kansas City Vamc
• Rajeev Kassal, M.D.
• Kcjse Inc
• Cimberly A. Lang, OTR
• Amy L Laws, PLPC
• Katie Elizabeth Lemaster, PT, DPT
• Amy Elizabeth Lewis
• Barry Meade Littlejohn, M.D.

• Community/Retail Pharmacy in Cameron, MO
• Providers in Cameron, MO by specialty
• Community/Retail Pharmacy in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2020; 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.