Provider Demographics
NPI:1831283316
Name:BKM INC
Entity Type:Organization
Organization Name:BKM INC
Other - Org Name:KEN'S U-SAVE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:RP IN CHARGE/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:L
Authorized Official - Last Name:MARVIN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD, RP
Authorized Official - Phone:402-826-3784
Mailing Address - Street 1:1302 LINDEN AVE
Mailing Address - Street 2:
Mailing Address - City:CRETE
Mailing Address - State:NE
Mailing Address - Zip Code:68333-1554
Mailing Address - Country:US
Mailing Address - Phone:402-826-3784
Mailing Address - Fax:402-826-5836
Practice Address - Street 1:1302 LINDEN AVE
Practice Address - Street 2:
Practice Address - City:CRETE
Practice Address - State:NE
Practice Address - Zip Code:68333-1554
Practice Address - Country:US
Practice Address - Phone:402-826-3784
Practice Address - Fax:402-826-5836
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE27093336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE=========00Medicaid
NE1125730001Medicare ID - Type Unspecified