Organization
KOHLL'S PHARMACY & HOMECARE
Active
Other names
PREVENTATIVE MEDICAL CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JUSTIN M KOHLL RPH (OWNER)
(402) 408-0012
Entity
Organization
Contact information
Practice address
624 N. 114TH ST, OMAHA, NE 68154
(402) 408-0012
(402) 408-0020
Mailing address
624 N. 114TH ST, OMAHA, NE 68154
(402) 408-0012
(402) 408-0020
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
09/27/2010
Last updated
09/27/2010
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