Organization
KJK LLC
Active
Other names
East Hickman Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER KONECNY PHARMD (CFO)
(732) 580-5805
Entity
Organization
Contact information
Practice address
7723 CLEARVIEW CHURCH LN, LYLES, TN 37098-1674
(931) 670-6035
(931) 670-6399
Mailing address
7723 CLEARVIEW CHURCH LN, LYLES, TN 37098-1674
(931) 670-6035
(931) 670-6399
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
1530
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2138079
PK
—
05
—
Q045581
—
TN
Enumeration date
11/26/2012
Last updated
01/17/2022
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