Provider Demographics
NPI:1619067535
Name:J & K DRUGS INC
Entity Type:Organization
Organization Name:J & K DRUGS INC
Other - Org Name:J AND K DRUG
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO-OWNER, PIC, AO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCKEITHEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-649-0825
Mailing Address - Street 1:PO BOX 1209
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:LA
Mailing Address - Zip Code:71418-1209
Mailing Address - Country:US
Mailing Address - Phone:318-649-0825
Mailing Address - Fax:318-649-0507
Practice Address - Street 1:7190 HIGHWAY 165
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:LA
Practice Address - Zip Code:71418-3302
Practice Address - Country:US
Practice Address - Phone:318-649-0825
Practice Address - Fax:318-649-0507
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-13
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336L0003X
LA30433336C0003X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2033295OtherPK
LA1262200Medicaid