KMART CORPORATION (NPI# 1083645048) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083645048 |
| Entity Type | Organization |
| Organization Name | KMART CORPORATION |
| Other Organization Name | KMART PHARMACY3958 |
| Practice Address |
2707 W Broadway St Princeton IN 47670-9420 |
| Practice Telephone | 8123863301 |
| Practice Fax Number | 8123865944 |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2007-07-08 |
| Authorized Official Name | DALE PURVIS (DIR THIRD PARTY ADMINISTRATION) |
| Authorized Official Telephone | 8472862927 |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 333600000X | Pharmacy | 60005797A | IN | Suppliers |
| X | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OTHER ID NUMBER-COMMERCIAL NUMBER | 1528427 | 01 |
| Other Name | Type Code |
|---|---|
| KMART PHARMACY3958 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619299146 | Kmart Corporation | Pharmacy | 545 Concord Pkwy N, Concord, NC 28027-6738 | 2010-02-25 |
| 1215968276 | Kmart Corporation | Pharmacy | 190 Stadium Dr, Defiance, OH 43512-4602 | 2006-07-06 |
| 1952332066 | Kmart Corporation | Pharmacy | 2400 W 29th St, Greeley, CO 80631-8525 | 2006-07-06 |
| 1275564320 | Kmart Corporation | Pharmacy | 210 Saratoga Rd, Scotia, NY 12302-4509 | 2006-07-06 |
| 1700817707 | Kmart Corporation | Pharmacy | 2705 Parleys Way, Salt Lake City, UT 84109-1619 | 2006-07-06 |
| 1467483461 | Kmart Corporation | Pharmacy | 1547 Highway 59 S, Thief River Falls, MN 56701-3413 | 2006-07-06 |
| 1932130085 | Kmart Corporation | Pharmacy | 15 Park Ave Ste 22, Clifton Park, NY 12065-2924 | 2006-07-06 |
| 1306877428 | Kmart Corporation | Pharmacy | 175 N West State Rd, American Fork, UT 84003-1485 | 2006-07-06 |
| 1427089556 | Kmart Corporation | Pharmacy | 4855 Summit Ridge Dr, Reno, NV 89523-7936 | 2006-07-06 |
| 1669403713 | Kmart Corporation | Pharmacy | 1075 Middle Country Rd, Middle Island, NY 11953-2514 | 2006-07-06 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Vermont Business Registrations | KMART CORPORATION | 3333 Beverly Rd., Hoffman Estates, IL 60179 |
| Oklahoma Business Registrations | KMART CORPORATION | 3100 W. Big Beaver Rd., Troy, MI 48084 |
| Street Address |
2707 W BROADWAY ST |
| City | PRINCETON |
| State | IN |
| Zip Code | 47670-9420 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871102384 | Chad Holzmeyer | Pharmacist | 101 W Brumfield Ave., Princeton, IN 47670 | 2020-07-30 |
| 1497383046 | Jessy Roy Emmett | Hearing Instrument Specialist | 205 West State Street, Suite 1, Princeton, IN 47670 | 2020-03-30 |
| 1033643010 | Deaconess Hospital, Inc | Durable Medical Equipment & Medical Supplies | 1416 W. Broadway St, Princeton, IN 47670 | 2017-04-17 |
| 1558782383 | Jon O'keefe | Marriage & Family Therapist | 304 North 5th Avenue, Princeton, IN 47670 | 2013-12-20 |
| 1376828616 | Andrea Catherine Kohlmeyer | Dietitian, Registered | 2340 E 350 S, Princeton, IN 47670 | 2011-10-19 |
| 1710192802 | Sarah Ellen Anderson | Pharmacy Technician | 2005 W Broadway, Princeton, IN 47670 | 2007-05-11 |
| 1760602296 | Buehlers Buy Low Pharmacy | Pharmacy Technician | 2005 W. Broadway, Princeton, IN 47670 | 2007-04-26 |
| 1114066511 | Jon Robb | Pharmacist | 4924 S Maple Tree Drive, Princeton, IN 47670 | 2007-02-05 |
| 1558464172 | M S Krishna | Pediatrics | 312 North 3rd Ave, Princeton, IN 47670 | 2006-09-07 |
| 1255353967 | Gibson County Auditor | Ambulance | 225 N Hart Street, Princeton, IN 47670 | 2006-07-24 |
| Find all providers in zip 47670 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| A 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. |
| 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: added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326573163 | Sante Princeton | Pharmacy | 200 Nassau St, Princeton, NJ 08542-4613 | 2017-05-01 |
| 1972969061 | Princeton Medical Pharmacy LLC | Pharmacy | 10 Forrestal Rd S Ste 102, Princeton, NJ 08540-6666 | 2016-01-06 |
| 1700919420 | Buehlers Buy Low Pharmacy | Pharmacy | 2005 W Broadway St, Princeton, IN 47670-1084 | 2007-03-13 |
| 1467526996 | Bentley Pharmacies Inc | Pharmacy | 528 W Water St, Princeton, WI 54968-9141 | 2006-11-17 |
| 1205934239 | Princeton Pharmacy | Pharmacy | 36 University Pl, Princeton, NJ 08540-5116 | 2006-09-21 |
| 1154439024 | Four Seasons Pharmacy Inc | Pharmacy | 300 Morrison Dr, Princeton, WV 24740-2765 | 2006-08-29 |
| 1497789275 | Kroger Limited Partnership I | Pharmacy | 1213 Stafford Dr, Princeton, WV 24740-2465 | 2006-07-10 |
| 1093757619 | Hickmans Prescription Druggist Inc | Pharmacy | 306 Rogers St, Princeton, WV 24740-3600 | 2006-06-11 |
| 1194764167 | Hickmans Prescription Druggist Inc | Pharmacy | 199 12th Street Ext, Princeton, WV 24740-2352 | 2006-06-05 |
| 1851360473 | Wegmans Food Markets, Inc. | Pharmacy | 240 Nassau Park Blvd, Attn: Pharmacy Manager, Princeton, NJ 08540-5993 | 2006-03-16 |
| Find all providers in PRINCETON | ||||
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| 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.