Healthcare Provider Details

I. General information

NPI: 1659201937
Provider Name (Legal Business Name): JKRX INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1304 E BOULEVARD AVE
BISMARCK ND
58501-4234
US

IV. Provider business mailing address

1304 E BOULEVARD AVE
BISMARCK ND
58501-4234
US

V. Phone/Fax

Practice location:
  • Phone: 701-224-0175
  • Fax: 701-224-1285
Mailing address:
  • Phone: 701-224-0175
  • Fax: 701-224-1285

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: TANYA BROSZ
Title or Position: PRESIDENT
Credential:
Phone: 701-224-0175