MEDICARE: KD DRUG, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336L0003X	Long Term Care Pharmacy

General Provider Information

NPI Number	:	1740008622
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KD DRUG, LLC

Provider Business Mailing Address
First Line	:	PO BOX 338
Second Line	:
City	:	GENOA
State	:	NE
Zip	:	68640-0338
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	508 WILLARD AVE
Second Line	:
City	:	GENOA
State	:	NE
Zip	:	68640-3039
Country	:	US
Telephone Number	:	402-993-3533
Fax Number	:	402-993-3530

Authorized Official
Title or Position	:	PRESIDENT/OWNER
Name	:	DR. TRAVIS KUCHAR
Credential	:	PHARMD, R.P.
Telephone Number	:	402-993-3533

Provider Enumeration Date	:	09/30/2024
Last Update Date	:	01/02/2025

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Directions to “KD DRUG, LLC ” Practice Location

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