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General NPI Number Information
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NPI Number | 1497869481
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Entity Type | Organization
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Legal Business Name | KCN NOVAK LLC
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Dates
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Enumeration Date | 08/18/2006
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Last Update Date | 09/19/2025
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Provider Practice Location Address
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Address Line | 709 HOLLYBROOK DR STE 101
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City | LONGVIEW
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State | TX
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Zip | 75605-2411
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Country | US
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Telephone | 903-234-8326
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Fax | 903-758-3808
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Provider Business Mailing Address
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Address Line | 615 N 3RD ST SUITE # 1
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City | LONGVIEW
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State | TX
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Zip | 75601-6550
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Country | US
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Telephone | 903-234-8329
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Fax | 903-247-9513
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Authorized Official
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Title or Position | OWNER
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Name | DON NOVAK
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Credential | RPH
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Telephone | 903-234-8326
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 15960
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License Number State | TX
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