Healthcare Provider Details

I. General information

NPI: 1730680414
Provider Name (Legal Business Name): KJK LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2018
Last Update Date: 10/27/2025
Certification Date: 10/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2340 FAIRVIEW BLVD. SUITE 300
FAIRVIEW TN
37062
US

IV. Provider business mailing address

2340 FAIRVIEW BLVD. SUITE 300
FAIRVIEW TN
37062
US

V. Phone/Fax

Practice location:
  • Phone: 615-446-8043
  • Fax: 615-446-7556
Mailing address:
  • Phone: 615-387-9000
  • Fax: 615-266-2362

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER PAUL KONECNY
Title or Position: CFO, OWNER, PHARMD
Credential:
Phone: 732-580-5805