Organization
KJ MEDICAL INC
Active
Other names
MEDICINE SHOPPE
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENT JENSEN RPH (PHARMACIST)
(208) 733-9242
Entity
Organization
Contact information
Practice address
615 FILER AVE, TWIN FALLS, ID 83301-4008
(208) 733-9242
(208) 733-2810
Mailing address
615 FILER AVE, TWIN FALLS, ID 83301-4008
(208) 733-9242
(208) 733-2810
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
1260CP
ID
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
1260CP
ID
332BX2000X
Oxygen Equipment & Supplies (DME)
1260CP
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
805009700
—
ID
Enumeration date
07/08/2008
Last updated
07/08/2008
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