Organization
KOHLLS PHARMACY & HOMECARE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID GEOFFREY KOHLL PHARM. D (PRESIDENT/OWNER)
(402) 895-6812
Entity
Organization
Contact information
Practice address
622 N 114TH ST, OMAHA, NE 68154-1571
(402) 408-0012
(402) 408-0020
Mailing address
12759 Q ST, OMAHA, NE 68137-3211
(402) 895-6812
(402) 895-7655
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
2239
NE
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
2239
NE
333600000X
Pharmacy
2239
NE
3336H0001X
Home Infusion Therapy Pharmacy
2239
NE
Other
Enumeration date
08/22/2005
Last updated
10/24/2017
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