Provider Demographics
NPI:1295771657
Name:KILBORNS INC
Entity type:Organization
Organization Name:KILBORNS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PIC
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:KILBORN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-551-5200
Mailing Address - Street 1:5203 LEAVENWORTH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68106-1345
Mailing Address - Country:US
Mailing Address - Phone:402-551-5200
Mailing Address - Fax:402-551-5050
Practice Address - Street 1:5203 LEAVENWORTH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68106-1345
Practice Address - Country:US
Practice Address - Phone:402-551-2000
Practice Address - Fax:402-551-5050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-22
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X
NE27613336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2055398OtherPK
NE=========00Medicaid
1129820001Medicare NSC