Organization Active NPI

Juan and John Drugs

Doing business as K & M Drugs

  • Community/Retail Pharmacy
  • Labelle, FL
National Provider Identifier
1972668176
Registry record updated Jun 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PH13694 Issued in FL
Legal business name
JUAN AND JOHN DRUGS
Doing business as
K & M Drugs
Practice address
149 Hwy 80 W
Labelle, FL 33935
Phone
(863) 675-0004
Fax
(863) 675-5030
NPI assigned
Dec 27, 2006
Last updated
Jun 29, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2016

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

Authorized official

Name
Haitham Kaki
Title
Owner, Pres
Phone
(863) 675-0004

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU
Pharmacy 333600000X NU
Community/Retail Pharmacy 3336C0003X PH13694 FL Primary

Addresses

Primary practice location

149 Hwy 80 W
Labelle, FL 33935

Mailing address

149 Hwy 80 W
Labelle, FL 33935
Phone (863) 675-0004

Other identifiers 2

IdentifierTypeStateIssuer
2009710OtherPK
103344000MedicaidFL

Other names 1

  • K & M Drugs Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090803000050 FL Part B Supplier - Mass Immunization (Roster Biller Only) 7416000872 1 other NPI on this enrollment
Practice locations: Clewiston, FL; Labelle, FL

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2217445Juan & John Drugs, Inc149 W Hwy 80, Labelle, FL 33935Certificate of waiverMar 21, 2027

National Provider Directory

National Provider Directory

Locations

340 E Sugarland Hwy
Ste H
Clewiston, FL 33440
Phone (863) 983-7277

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467158400000",
    "number": "1972668176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "149 HWY 80 W",
            "city": "LABELLE",
            "state": "FL",
            "postal_code": "33935",
            "telephone_number": "863-675-0004",
            "fax_number": "863-675-5030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "149 HWY 80 W",
            "city": "LABELLE",
            "state": "FL",
            "postal_code": "33935",
            "telephone_number": "863-675-0004",
            "fax_number": "863-675-5030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUAN AND JOHN DRUGS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-27",
        "last_updated": "2016-06-29",
        "status": "A",
        "authorized_official_last_name": "KAKI",
        "authorized_official_first_name": "HAITHAM",
        "authorized_official_title_or_position": "OWNER, PRES",
        "authorized_official_telephone_number": "863-675-0004"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "FL",
            "license": "PH13694",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2009710",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103344000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "K & M Drugs",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Labelle, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.