Provider Demographics
NPI:1104480151
Name:J3A INC
Entity type:Organization
Organization Name:J3A INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:HAMIK
Authorized Official - Suffix:
Authorized Official - Credentials:RP
Authorized Official - Phone:308-293-0816
Mailing Address - Street 1:3611 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68847-8104
Mailing Address - Country:US
Mailing Address - Phone:308-455-1555
Mailing Address - Fax:308-708-2699
Practice Address - Street 1:3611 2ND AVE
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68847-8104
Practice Address - Country:US
Practice Address - Phone:308-455-1555
Practice Address - Fax:308-708-2699
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-25
Last Update Date:2019-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy