KV MEDICAL LLC. NPI 1073086807

NPI Details

KV MEDICAL LLC. is a community/retail pharmacy pharmacy in Newport, TN. The provider is a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. KV MEDICAL LLC. NPI is 1073086807. The provider is registered as an organization entity type.
The provider Is Doing Business As Broadway & Main Pharmacy.

The provider's business location address is:

136 E. BROADWAY
NEWPORT, TN
ZIP 37821-323
Phone: (423) 720-9777
Fax: (423) 720-9778

The provider's authorized official is Justin Kickliter .
The authorized official title is Pic and has the following contact phone number (423) 720-9777.

The CLIA number assigned to this NPI record is 44D2186778 - pharmacy with a certificate type of Certificate of Waiver.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

• Intramuscular administration of single severe acute respiratory syndrome coronavirus 2 (covid-19) vaccine, mrna-lnp, spike protein, preservative free, 100 mcg/0.5ml dosage; second dose (HCPCS:0012A)
• Intramuscular administration of single severe acute respiratory syndrome coronavirus 2 (covid-19) vaccine, mrna-lnp, spike protein, preservative free, 100 mcg/0.5ml dosage; first dose (HCPCS:0011A)
• Administration of influenza virus vaccine (HCPCS:G0008)
• Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage (HCPCS:90694)

The enumeration date for this NPI number is 1/4/2019 and was last updated on 7/8/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.