Provider Demographics
NPI:1669974093
Name:JK TRAINER, INC
Entity type:Organization
Organization Name:JK TRAINER, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:W
Authorized Official - Last Name:KLEMKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-650-7191
Mailing Address - Street 1:801 S DEWEY ST
Mailing Address - Street 2:
Mailing Address - City:NORTH PLATTE
Mailing Address - State:NE
Mailing Address - Zip Code:69101-5524
Mailing Address - Country:US
Mailing Address - Phone:402-606-4204
Mailing Address - Fax:402-606-4210
Practice Address - Street 1:801 S DEWEY ST
Practice Address - Street 2:
Practice Address - City:NORTH PLATTE
Practice Address - State:NE
Practice Address - Zip Code:69101-5524
Practice Address - Country:US
Practice Address - Phone:402-606-4204
Practice Address - Fax:402-606-4210
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JK TRAINER, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-03-01
Last Update Date:2018-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies