Organization
JLKGT INVESTMENTS LLC
Active
Other names
KAUP PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUELYN BRISCOE (OWNER)
(937) 526-3337
Entity
Organization
Contact information
Practice address
42 W MAIN ST, VERSAILLES, OH 45380-1214
(937) 526-3337
(937) 526-4118
Mailing address
42 W MAIN ST, VERSAILLES, OH 45380-1214
(937) 526-3337
(937) 526-4118
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
022452100
OH
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0112030
—
OH
01
—
2148087
PK
—
Enumeration date
10/20/2006
Last updated
02/20/2017
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