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General NPI Number Information
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NPI Number | 1831283316
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Entity Type | Organization
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Legal Business Name | BKM INC
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1302 LINDEN AVE
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City | CRETE
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State | NE
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Zip | 68333-1554
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Country | US
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Telephone | 402-826-3784
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Fax | 402-826-5836
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Provider Business Mailing Address
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Address Line | 1302 LINDEN AVE
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City | CRETE
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State | NE
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Zip | 68333-1554
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Country | US
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Telephone | 402-826-3784
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Fax | 402-826-5836
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Authorized Official
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Title or Position | RP IN CHARGE/OWNER
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Name | DR. KENNETH L MARVIN
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Credential | PHARM.D., RP
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Telephone | 402-826-3784
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 2709
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License Number State | NE
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