NPIMap

Organization Active NPI

Kubat Pharmacy, LLC

  • Community/Retail Pharmacy
  • Omaha, NE
National Provider Identifier
1851400824
Registry record updated Jun 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
KUBAT PHARMACY, LLC
Practice address
2401 N St
Omaha, NE 68107-2708
Phone
(402) 731-4333
Fax
(402) 734-8824
NPI assigned
Aug 30, 2006
Organization subpart
Yes
Parent organization
PERCIPIO KP HOLDINGS, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 3, 2021

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

Authorized official

Name
Mr. Brian Paul Daniel
Title
Chief Operating Officer
Phone
(402) 315-1944

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

2401 N St
Omaha, NE 68107-2708

Mailing address

4924 Center St
Omaha, NE 68106-3219
Phone (402) 558-8888

Other identifiers 2

IdentifierTypeStateIssuer
10025435200MedicaidNE
2817318OtherNCPDP

Other names 2

  • Kubat HealthCare Doing business as
  • Kubat Pharmacy, Inc. Former legal business name

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

2401 N St
Omaha, NE 68107
Phone (402) 731-4333

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622678400000",
    "number": "1851400824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4924 CENTER ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681063219",
            "telephone_number": "402-558-8888",
            "fax_number": "402-558-7388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 N ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681072708",
            "telephone_number": "402-731-4333",
            "fax_number": "402-734-8824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KUBAT PHARMACY, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PERCIPIO KP HOLDINGS, LLC",
        "enumeration_date": "2006-08-30",
        "last_updated": "2021-06-03",
        "certification_date": "2021-06-02",
        "status": "A",
        "authorized_official_last_name": "DANIEL",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "402-315-1944",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025435200",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "2817318",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kubat HealthCare",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Kubat Pharmacy, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Kubat Pharmacy, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2021; 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.