Organization
KOHLL'S PHARMACY & HOMECARE INC
Active
Other names
PREVENTATIVE MEDICAL CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JUSTIN M KOHLL RPH (OWNER)
(402) 108-0012
Entity
Organization
Contact information
Practice address
12741 Q ST, OMAHA, NE 68137-3211
(402) 895-6812
(402) 895-7655
Mailing address
12741 Q ST, OMAHA, NE 68137-3211
(402) 895-6812
(402) 895-7655
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
10/06/2010
Last updated
01/12/2011
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