NPIMap

Organization Active NPI

KJ Medical Inc

Doing business as Medicine Shoppe

  • Durable Medical Equipment & Medical Supplies
  • Twin Falls, ID
National Provider Identifier
1902069172
Registry record updated Jul 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
1260CP Issued in ID
Legal business name
KJ MEDICAL INC
Doing business as
Medicine Shoppe
Practice address
615 Filer Ave
Twin Falls, ID 83301-4008
Phone
(208) 733-9242
Fax
(208) 733-2810
NPI assigned
Jul 8, 2008
Last updated
Jul 8, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2008

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

Authorized official

Name
Mr. Kent Jensen, RPH
Title
Pharmacist
Phone
(208) 733-9242

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 1260CP ID Primary
Parenteral & Enteral Nutrition Supplies (DME) 332BP3500X 1260CP ID
Oxygen Equipment & Supplies (DME) 332BX2000X 1260CP ID

Addresses

Primary practice location

615 Filer Ave
Twin Falls, ID 83301-4008

Mailing address

615 Filer Ave
Twin Falls, ID 83301-4008
Phone (208) 733-9242

Other identifiers 1

IdentifierTypeStateIssuer
805009700MedicaidID

Other names 1

  • MEDICINE SHOPPE Doing business as

National Provider Directory

National Provider Directory

Locations

615 Filer Ave
Twin Falls, ID 83301
Phone (208) 733-9242

NPI Registry JSON

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

{
    "created_epoch": "1215475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215475200000",
    "number": "1902069172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 FILER AVE",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833014008",
            "telephone_number": "208-733-9242",
            "fax_number": "208-733-2810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 FILER AVE",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833014008",
            "telephone_number": "208-733-9242",
            "fax_number": "208-733-2810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KJ MEDICAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-08",
        "last_updated": "2008-07-08",
        "status": "A",
        "authorized_official_last_name": "JENSEN",
        "authorized_official_first_name": "KENT",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "208-733-9242",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "ID",
            "license": "1260CP",
            "primary": true
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": "ID",
            "license": "1260CP",
            "primary": false
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "ID",
            "license": "1260CP",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "805009700",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MEDICINE SHOPPE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Twin Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2008; 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.