K MART CORP (NPI# 1073544037) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1073544037 |
Entity Type | Organization |
Organization Name | K MART CORP |
Other Organization Name | KMART PHARMACY3254 |
Practice Address |
820 N Coliseum Blvd Fort Wayne IN 46805-5516 |
Mailing Address |
3333 Beverly Rd Ac 367 B Hoffman Estates IL 60179-0001 |
Practice Telephone | 2604260369 |
Practice Fax Number | 2604203065 |
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 |
60005812A | IN | Suppliers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
PK | 2027723 | 01 | |
IN | 100454880A | 05 |
Other Name | Type Code |
---|---|
KMART PHARMACY3254 | 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 |
820 N COLISEUM BLVD |
City | FORT WAYNE |
State | IN |
Zip Code | 46805-5516 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1811219090 | Michael Wayne Hosier | Pharmacist | 820 N Coliseum Blvd, Fort Wayne, IN 46805-5516 | 2010-02-16 |
1558761718 | Michael Knabel | Pharmacist | 820 N Coliseum Blvd, Fort Wayne, IN 46805-5516 | 2014-08-25 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1619589546 | Connor Gemlick | Student in an Organized Health Care Education/Training Program | 1918 Carew St., Fort Wayne, IN 46805 | 2020-08-21 |
1710464086 | S.t.a.r. Care Services | Clinic/Center | 3521 Lake Avenue, Suite #4, Fort Wayne, IN 46805 | 2018-07-19 |
1083122865 | Noel Shafi | Counselor | 3010 East State Boulevard, Fort Wayne, IN 46805 | 2018-01-16 |
1063963627 | Toni L Irby | Specialist | 3219 E State Blvd, Fort Wayne, IN 46805 | 2016-10-19 |
1639626211 | Logan Schwerer | Pharmacist | 923 Northcrest Business Center 6d, Fort Wayne, IN 46805 | 2016-09-01 |
1063817104 | Michale Diane Rothgeb | Physical Therapy Assistant | 2200 Randollia Dr, Fort Wayne, IN 46805 | 2014-10-31 |
1124435789 | Julia I. Mcfann | Physical Therapist | 2200 Randalia Dr, Fort Wayne, IN 46805 | 2014-07-16 |
1083036974 | Capital Senior Living Properties 4, Inc. | Assisted Living Facility | 3320 East State Boulevard, Fort Wayne, IN 46805 | 2014-01-10 |
1356772396 | Alexander James Medical Supply | Durable Medical Equipment & Medical Supplies | 2200 Lake Avenue, Suite 290, Fort Wayne, IN 46805 | 2013-12-02 |
1043595689 | Randy James Jennings | Pharmacist | 923 Northcrest Business Center, 6-d, Fort Wayne, IN 46805 | 2011-10-14 |
Find all providers in zip 46805 |
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 |
---|---|---|---|---|
1659576395 | Kroger Limited Partnership I | Pharmacy | 5300 Decatur Rd, Fort Wayne, IN 46806-3058 | 2007-06-20 |
1427253756 | Kroger Limited Partnership I | Pharmacy | 7008 Bluffton Rd, Fort Wayne, IN 46809-2706 | 2007-06-18 |
1689879074 | Kroger Limited Partnership I | Pharmacy | 1125 W State Blvd, Fort Wayne, IN 46808-3185 | 2007-06-18 |
1578768974 | Kroger Limited Partnership I | Pharmacy | 6310 E State Blvd, Fort Wayne, IN 46815-7023 | 2007-06-18 |
1679778989 | Kroger Limited Partnership I | Pharmacy | 10230 Chestnut Plaza Dr, Fort Wayne, IN 46814-8970 | 2007-06-18 |
1275737355 | Kroger Limited Partnership I | Pharmacy | 710 E Dupont Rd, Fort Wayne, IN 46825-2056 | 2007-06-13 |
1790989879 | Kroger Limited Partnership I | Pharmacy | 4120 N Clinton St, Fort Wayne, IN 46805-1230 | 2007-06-13 |
1043414121 | Kroser Limited Phartnership I | Pharmacy | 3105 N Anthony Blvd, Fort Wayne, IN 46805-2227 | 2007-06-13 |
1275636961 | Hook Superx LLC | Pharmacy | 2811 Getz Rd, Fort Wayne, IN 46804-3064 | 2006-09-07 |
1588767297 | Hook Superx LLC | Pharmacy | 7330 Lima Rd, Fort Wayne, IN 46818-1130 | 2006-09-07 |
Find all providers in FORT WAYNE |
City | FORT WAYNE |
Zip Code | 46805 |
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.