KCKLG LLC NPI 1124678453

Pharmacy in Las Vegas, NV

Organization Pharmacy

About KCKLG LLC

Kcklg Llc is a provider established in Las Vegas, Nevada specializing in pharmacy. The NPI number of Kcklg Llc is 1124678453 and was assigned on September 2019. The practitioner's primary taxonomy code is 333600000X. The provider is registered as an organization and their NPI record was last updated September 2019. The authorized official of this NPI record is Laylani Macaraeg (Owner)

NPI

1124678453

Provider NameKCKLG LLC
Provider Location Address6496 MEDICAL CENTER ST STE 101 LAS VEGAS, NV 89148
Provider Mailing Address6496 MEDICAL CENTER ST STE 101 LAS VEGAS, NV 89148
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date09-18-2019
Last Update Date09-18-2019

Primary Taxonomy

Taxonomy Code333600000X
ClassificationPharmacy
TypeSuppliers
Taxonomy DescriptionA facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

Business Address

KCKLG LLC
6496 MEDICAL CENTER ST STE 101
LAS VEGAS, NV
ZIP 89148
Phone: (702) 749-7404
Fax: (702) 749-7414

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Mailing Address

KCKLG LLC
6496 MEDICAL CENTER ST STE 101
LAS VEGAS, NV
ZIP 89148
Phone: (702) 749-7404
Fax: (702) 749-7414

Authorized Official

Authorized Official Name LAYLANI MACARAEG
Authorized Official TitleOWNER
Authorized Official Phone(702) 374-7344

Secondary Taxonomies


The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.

No. Taxonomy Code Type Classification Specialization License No. State Primary
13336C0003XSuppliersPharmacyCommunity/Retail PharmacyNo

Taxonomy Description: 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.

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.

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