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PREVENTATIVE MEDICAL CLINIC
NPI 1508175480
Nurse Practitioner - Family in Omaha, NE

Active since September 27, 2010
624 N. 114TH ST, OMAHA, NE 68154(402) 408-0012(402) 408-0020 Get Directions Write a Review

NPPES record last updated: September 27, 2010. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Preventative Medical Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PREVENTATIVE MEDICAL CLINIC (NPI 1508175480) is a healthcare organization registered as a family in Omaha, Nebraska and active in the NPI registry since September 2010. The organization lists Justin M Kohll, Owner, as its authorized official.

NPPES Registry Identity

NPI1508175480
Entity TypeOrganization
Primary Taxonomy363LF0000X
Legal Business NameKOHLL'S PHARMACY & HOMECARE
Location Address624 N. 114TH STOmaha, NE 68154
Mailing Address624 N. 114th StOmaha, NE 68154 · (402) 408-0012 · Fax (402) 408-0020
Phone(402) 408-0012
Fax(402) 408-0020
Organization SubpartNo
Authorized OfficialJustin M KohllOwner · (402) 408-0012
Enumeration DateSeptember 27, 2010
✔ NPI 1508175480 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
624 N. 114TH ST, Omaha, NE 68154
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Other Names 1

Doing Business AsPreventative Medical Clinic

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kohll's Pharmacy & Homecare's NPI number?

The NPI number for Kohll's Pharmacy & Homecare is 1508175480. It was assigned to this organization in the NPPES registry on September 27, 2010. The provider is doing business as Preventative Medical Clinic.

Where is Kohll's Pharmacy & Homecare located?

Kohll's Pharmacy & Homecare is located at 624 N. 114th St, Omaha, NE 68154. The listed phone number is (402) 408-0012.

What is Kohll's Pharmacy & Homecare's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

When was this NPI record last updated?

The NPPES record for Kohll's Pharmacy & Homecare was last updated on September 27, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.