K MART CORP (NPI# 1104857176) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104857176 |
| Entity Type | Organization |
| Organization Name | K MART CORP |
| Other Organization Name | KMART PHARMACY4171 |
| Practice Address |
4200 W Kellogg Dr Wichita KS 67209-2269 |
| Mailing Address |
3333 Beverly Rd Ac 367 B Hoffman Estates IL 60179-0001 |
| Practice Telephone | 3169428253 |
| Practice Fax Number | 3169426730 |
| Mailing Telephone | 8472864089 |
| Mailing Fax Number | 8472861603 |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2015-02-04 |
| Authorized Official Name | JENNIFER SPEARES (DIR. OF COMPLIANCE AND ADMIN.) |
| Authorized Official Telephone | 8472865116 |
| 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 |
2-09802 | KS | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KS | 100435980B | 05 | |
| PK | 2031398 | 01 | |
| KS | 6014453809 | 05 |
| Other Name | Type Code |
|---|---|
| KMART PHARMACY4171 | 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 |
4200 W KELLOGG DR |
| City | WICHITA |
| State | KS |
| Zip Code | 67209-2269 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588996813 | Mark A Lahasky | Pharmacist | 4200 W Kellogg Dr, Wichita, KS 67209-2269 | 2010-02-11 |
| 1871995837 | Stephen Kyle Bliss | Pharmacist | 4200 W Kellogg Dr, Wichita, KS 67209-2269 | 2014-09-22 |
| 1578983482 | Ngozi Rosemary Iweha | Pharmacist | 4200 W Kellogg Dr, Wichita, KS 67209-2269 | 2014-04-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124634878 | Vonda Jeanne Foster | Pharmacist | 1402 S. Ridge Rd, Wichita, KS 67209 | 2020-09-18 |
| 1780290437 | Gaia R Priddle | Pharmacist | 1402 S Ridge Road, Wichita, KS 67209 | 2020-09-18 |
| 1134735889 | Thomas Allan Ruesch | Pharmacist | 1402 South Ridge Road, Wichita, KS 67209 | 2020-09-18 |
| 1619454337 | Zachary Hill | Pharmacist | 6110 W Kellogg, Wichita, KS 67209 | 2018-07-25 |
| 1922401785 | Jesse C Hidalgo Jr. | Hearing Instrument Specialist | 10318 W Maple St, Wichita, KS 67209 | 2014-10-07 |
| 1932458106 | West Wichita Assisted Living, LLC | Assisted Living Facility | 629 S. Maize Ct, Wichita, KS 67209 | 2012-09-04 |
| 1669782231 | Gracious Senior Living, LLC | Nursing Facility/Intermediate Care Facility | 551 S. Holland, Wichita, KS 67209 | 2010-10-18 |
| 1740598044 | Devin Jeanne Vrana | Chiropractor | 1247 S Tyler Rd, Wichita, KS 67209 | 2010-09-21 |
| 1881881019 | Jessica Harmon | Counselor | 501 S Turquoise St, Wichita, KS 67209 | 2007-10-02 |
| 1225246317 | Sullivan Gang Care Center | Technician | 6719 W. Douglas Circle, Wichita, KS 67209 | 2007-05-20 |
| Find all providers in zip 67209 | ||||
| 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 |
|---|---|---|---|---|
| 1174132161 | Ascension Via Christi Hospitals Wichita Inc. | Pharmacy | 3600 E Harry St Rm 2001, Wichita, KS 67218-3713 | 2020-07-27 |
| 1356807044 | Dandurand Wellness, Inc. | Pharmacy | 550 N Hillside St Ste 3-100, Wichita, KS 67214-4910 | 2019-02-18 |
| 1548737182 | West Wichita Family Pharmacy LLC | Pharmacy | 8200 W Central Ave Ste 5, Wichita, KS 67212-3661 | 2018-11-01 |
| 1629588454 | Neighborhood Pharmacy 0002 LLC | Pharmacy | 328 E Pawnee St, Wichita, KS 67211-4847 | 2017-10-06 |
| 1548711484 | Wal-mart Pharmacy | Pharmacy | 2200 S Rock Rd, Apartment 1014, Wichita, KS 67207-5300 | 2016-10-15 |
| 1245623677 | Costco Wholesale Corporation | Pharmacy | 9700 E. Kellogg, Wichita, KS 67207 | 2015-03-10 |
| 1184967804 | Davis Family Pharmacy, LLC | Pharmacy | 2131 N Ridge Rd Ste 103, Wichita, KS 67212-1571 | 2013-04-01 |
| 1447578216 | Kwik Shop Inc | Pharmacy | 7107 W 37th St N, Wichita, KS 67205-9360 | 2010-05-04 |
| 1710002811 | Hac Inc | Pharmacy | 1910 W 21st St N, Wichita, KS 67203-2105 | 2007-03-20 |
| 1013072289 | Rcr East, LLC | Pharmacy | 2350 N Greenwich Rd, Suite 1000, Wichita, KS 67226-8269 | 2006-12-27 |
| Find all providers in WICHITA | ||||
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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.