K MART CORP (NPI# 1023049087) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023049087 |
| Entity Type | Organization |
| Organization Name | K MART CORP |
| Other Organization Name | KMART PHARMACY4203 |
| Practice Address |
7425 E Washington St Indianapolis IN 46219-6749 |
| Mailing Address |
3333 Beverly Rd Ac 367 B Hoffman Estates IL 60179-0001 |
| Practice Telephone | 3173596389 |
| Practice Fax Number | 3173572930 |
| Mailing Telephone | 8472864089 |
| Mailing Fax Number | 8472861603 |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2014-10-30 |
| Authorized Official Name | DAIN RUSK (VP/GM PHARMACY) |
| Authorized Official Telephone | 8472863348 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
60005796A | IN | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2026064 | 01 | |
| IN | 100297110A | 05 |
| Other Name | Type Code |
|---|---|
| KMART PHARMACY4203 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841621695 | K Mart Corp | Pharmacy | 25 W Polk St, Coalinga, CA 93210-2366 | 2013-12-04 |
| 1437397411 | K Mart Corp | Pharmacy | Carr. Pr-156 Km 54.00, Las Catalinas Mall, Local 4858, Caguas, PR 00726 | 2009-01-28 |
| 1336256007 | K Mart Corp | Pharmacy | 3625 E 18th St, Antioch, CA 94509-8511 | 2006-08-25 |
| 1205943974 | K Mart Corp | Pharmacy | 1050 N Davis Rd, Salinas, CA 93907-1944 | 2006-08-25 |
| 1437177102 | K Mart Corp | Pharmacy | 5665 Rosemead Blvd, Temple City, CA 91780-1804 | 2006-07-18 |
| 1154352284 | K Mart Corp | Pharmacy | Rte 12 A, West Lebanon, NH 03784 | 2006-07-06 |
| 1093746117 | K Mart Corp | Pharmacy | 1501 Us 1, Vero Beach, FL 32960-5735 | 2006-07-06 |
| 1417988486 | K Mart Corp | Pharmacy | 1581 Us 68, Maysville, KY 41056-9178 | 2006-07-06 |
| 1902837040 | K Mart Corp | Pharmacy | Route 70 E, Marlton, NJ 08053 | 2006-07-06 |
| 1780615815 | K Mart Corp | Pharmacy | 129 Mall Rd, Covington, VA 24426-2413 | 2006-07-06 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | K MART CORPORATION | 3333 Beverly Road, Hoffman Estates, IL 60179 |
| Iowa Business Entities | K MART CORPORATION | 3333 Beverly Road, Hoffman Estates, IL 60179 |
| Connecticut Business Registrations | K MART CORPORATION | 3333 Beverly Road, Hoffman Estates, IL 60179 |
| Oregon Corporations, Companies and Business Names | K MART CORPORATION | 3333 Beverly Rd, Hoffman Estates, IL 60179 |
| Virginia Business Entities | K MART CORPORATION | 3333 Beverly Rd, Hoffman Estates, Illinois 60179 |
| New York State Corporations | K MART CORPORATION | 28 Liberty St., New York, New York 10005 |
| Oklahoma Business Registrations | K MART CORPORATION | 3333 Beverly Rd, Hoffman Estates, IL 60179 |
| Street Address |
7425 E WASHINGTON ST |
| City | INDIANAPOLIS |
| State | IN |
| Zip Code | 46219-6749 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275865420 | Goda Tribandyte | Pharmacist | 7425 E Washington St, Indianapolis, IN 46219-6749 | 2010-02-12 |
| 1407106388 | John Lewis Crenshaw | Pharmacist | 7425 E Washington St, Indianapolis, IN 46219-6749 | 2012-09-18 |
| 1366774598 | John F Mchenry | Pharmacist | 7425 E Washington St, Indianapolis, IN 46219-6749 | 2010-02-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518571157 | Kara Kathryn Berning | Dietitian, Registered | 2040 N. Shadeland Ave, Suite 130, Indianapolis, IN 46219 | 2020-09-01 |
| 1780223750 | Erin Cannon | Specialist | 1543 N Post Rd, Indianapolis, IN 46219 | 2019-12-23 |
| 1073151239 | Tanicka Elizabeth Word | Behavior Technician | 6635 E 21st Street, West Building, Indianapolis, IN 46219 | 2019-12-18 |
| 1790322527 | Arlington Westend Dental LLC | Dentist | 5900 E 10th St, Indianapolis, IN 46219 | 2019-11-27 |
| 1336645985 | Lynell Westbrook Gates | Counselor | 1311 N Arlington Ave Ste 102, Indianapolis, IN 46219 | 2018-04-03 |
| 1861991689 | Comfort Dental LLC | Clinic/Center | 8151 E 21st St., Indianapolis, Indianapolis, IN 46219 | 2018-02-07 |
| 1467811570 | Fresenius Medical Care Indiana, LLC | Clinic/Center | 6701 E 21st St, Indianapolis, IN 46219 | 2016-02-17 |
| 1992197289 | Casey Baker | Physician Assistant | 1500 N Ritter Ave (medical Associates, LLP), Indianapolis, IN 46219 | 2015-02-24 |
| 1811398407 | Adam Romesser | Pharmacist | 8907 E. 10th St., Indianapolis, IN 46219 | 2014-09-15 |
| 1225448673 | Justin Stauffer | Pharmacist | 5903 E Pleasant Run Parkway North Dr, Indianapolis, IN 46219 | 2014-05-06 |
| Find all providers in zip 46219 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| 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. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669095261 | Abi Westend Pharmacy | Pharmacy | 602 N High School Rd Ste A-1, Indianapolis, IN 46214-3694 | 2020-05-19 |
| 1346898889 | Milan Pharmacy Inc | Pharmacy | 1935 N Capitol Ave Ste 120, Indianapolis, IN 46202-6403 | 2019-08-28 |
| 1669951471 | Community Health Network, Inc | Pharmacy | 7250 Clearvista Dr Ste 140, Indianapolis, IN 46256-4640 | 2018-08-13 |
| 1871084798 | Sd&j LLC T A Made-in Indianapolis Pharmacy & Medical Equipment | Pharmacy | 3350 N High School Rd Ste J, Indianapolis, IN 46224-2050 | 2018-05-25 |
| 1265931638 | Indy Scripts Inc | Pharmacy | 5343 W 38th St, Indianapolis, IN 46254-2900 | 2018-02-12 |
| 1003345703 | Carepoint Indiana LLC | Pharmacy | 7305 E 96th St, Indianapolis, IN 46250-3311 | 2017-06-06 |
| 1396138814 | H3 Pharmacy, Inc | Pharmacy | 9539 Valparaiso Ct, Indianapolis, IN 46268-1130 | 2015-03-08 |
| 1730586900 | Simple Meds, LLC | Pharmacy | 6862 Hillsdale Ct, Indianapolis, IN 46250-2001 | 2014-12-03 |
| 1063811339 | Healthscripts of America-indianapolis, LLC | Pharmacy | 8840 Michigan Rd Ste 100, Indianapolis, IN 46268-1440 | 2014-08-22 |
| 1790111680 | The Health and Hospital Corporation of Marion County | Pharmacy | 5515 W 38th St Ste 1200, Indianapolis, IN 46254 | 2013-09-24 |
| Find all providers in INDIANAPOLIS | ||||
| City | INDIANAPOLIS |
| Zip Code | 46219 |
Please comment or provide details below to improve the information on K MART CORP.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.