Provider Demographics
NPI:1578345492
Name:J3A INC
Entity Type:Organization
Organization Name:J3A INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PIC
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:HAMIK
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:308-455-1555
Mailing Address - Street 1:3611 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68847-8104
Mailing Address - Country:US
Mailing Address - Phone:308-455-1555
Mailing Address - Fax:308-708-2699
Practice Address - Street 1:3611 2ND AVE
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68847-8104
Practice Address - Country:US
Practice Address - Phone:308-455-1555
Practice Address - Fax:308-708-2699
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:J3A INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-10-16
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy