KMART OPERATIONS LLC (NPI# 1164453122) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164453122 |
| Entity Type | Organization |
| Organization Name | KMART OPERATIONS LLC |
| Other Organization Name | KMART PHARMACY3556 |
| Practice Address |
3101 Northview Dr Elkhart IN 46514-6748 |
| Mailing Address |
3333 Beverly Rd Ac 367 B Hoffman Estates IL 60179-0001 |
| Practice Telephone | 5742665582 |
| Practice Fax Number | 5742667887 |
| Mailing Telephone | 8472864089 |
| Mailing Fax Number | 8472861603 |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2016-07-07 |
| 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 |
60006492A | IN | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2027630 | 01 | |
| IN | 100462360A | 05 |
| Other Name | Type Code |
|---|---|
| KMART PHARMACY3556 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346271475 | Kmart Operations LLC | Pharmacy | 4700 2nd Ave, Kearney, NE 68847-2418 | 2006-07-06 |
| 1174554281 | Kmart Operations LLC | Pharmacy | 2821 E Main St, Russellville, AR 72802-9662 | 2006-07-06 |
| 1982635009 | Kmart Operations LLC | Pharmacy | 2308 Highway 45 N, Columbus, MS 39705-1745 | 2006-07-06 |
| 1982635033 | Kmart Operations LLC | Pharmacy | 1425 E Highway 151, Platteville, WI 53818 | 2006-07-06 |
| 1245261395 | Kmart Operations LLC | Pharmacy | 2150 S Douglas Hwy, Gillette, WY 82718-5416 | 2006-07-06 |
| 1174554208 | Kmart Operations LLC | Durable Medical Equipment & Medical Supplies | 3180 Highway 2 West, Havre, MT 59501 | 2006-07-06 |
| 1427089416 | Kmart Operations LLC | Pharmacy | 1560 Us Highway 31 S, Manistee, MI 49660-2223 | 2006-07-06 |
| 1417988536 | Kmart Operations LLC | Pharmacy | 11 S Kingshighway St # 61, Cape Girardeau, MO 63703-5742 | 2006-07-06 |
| 1366473472 | Kmart Operations LLC | Pharmacy | 2011 E Fry Blvd, Sierra Vista, AZ 85635-2753 | 2006-07-06 |
| 1912938911 | Kmart Operations LLC | Pharmacy | 1305 Highway 10 W, Detroit Lakes, MN 56501-2214 | 2006-07-06 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Iowa Business Entities | KMART OPERATIONS LLC | 3333 Beverly Rd B2126b, Hoffman Estates, IL 60179 |
| Oregon Corporations, Companies and Business Names | KMART OPERATIONS LLC | 3333 Beverly Rd B2-101b, Hoffman Estates, IL 60179 |
| Washington State Corporations | KMART OPERATIONS LLC | 3333 Beverly Rd, Hoffman Est, IL 60179-0001 |
| New York State Corporations | KMART OPERATIONS LLC | 28 Liberty St., New York, Ny 10005 |
| Colorado Business Entities | Kmart Operations LLC | 3333 Beverly Road, B2-116b, Hoffman Estates, IL 60179 |
| Massachusetts Corporations | KMART OPERATIONS LLC | 3333 Beverly Rd. B2-126b, Hoffman Estates, IL 60179 |
| Indiana Business Entities | KMART OPERATIONS LLC | 3333 Beverly Rd, B2-126b, Hoffman Estates, IL 60179 |
| Ohio Business Entities | KMART OPERATIONS LLC | 3333 Beverly Road, Corporate Secretary, Hoffman Estates, IL 60179 |
| Street Address |
3101 NORTHVIEW DR |
| City | ELKHART |
| State | IN |
| Zip Code | 46514-6748 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043644230 | Susan Widup | Pharmacist | 3101 Northview Dr, Elkhart, IN 46514-6748 | 2013-08-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891333522 | Adam Collier | Nurse Anesthetist, Certified Registered | 600 Elkhart Boulvard, Elkhart, IN 46514 | 2019-12-12 |
| 1861034688 | Heart City Health Center, Inc. | Obstetrics & Gynecology | 1545 Cassopolis Street, Elkhart, IN 46514 | 2019-10-14 |
| 1982263398 | Fresenius Medical Care North Elkhart, LLC | Clinic/Center | 801 W Bristol St, Elkhart, IN 46514 | 2019-06-10 |
| 1487118220 | Hellenic Senior Living of Elkhart, LLC | Assisted Living Facility | 2528 Bypass Road, Elkhart, IN 46514 | 2019-01-25 |
| 1922595792 | Anna Cornelia Smith | Nutritionist | 51803 Tall Pines Dr, Elkhart, IN 46514 | 2018-04-17 |
| 1114438496 | Erika Lynn Farrell | Counselor | 3120 Suite B Windsor Court, Elkhart, IN 46514 | 2017-10-13 |
| 1740728948 | Michael Scheretie | Nurse Anesthetist, Certified Registered | 52866 Wildflower Ln, Elkhart, IN 46514 | 2017-02-08 |
| 1821355876 | Marcy Lynn Adams | Nurse Practitioner | 1104 W Bristol St, Elkhart, IN 46514 | 2012-04-16 |
| 1053694265 | Paul A. Price | Pharmacist | 1400 Cassopolis St., Elkhart, IN 46514 | 2011-09-23 |
| 1528362647 | Beacon Medical Group, Inc. | Internal Medicine | 500 Arcade Ave., Suite 400, Elkhart, IN 46514 | 2011-01-04 |
| Find all providers in zip 46514 | ||||
| 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 |
|---|---|---|---|---|
| 1528397643 | Martins Super Markets Inc | Pharmacy | 120 Sanford School Rd, Ste B, Elkhart, IN 46514 | 2009-12-19 |
| 1043485568 | Walgreen Co | Pharmacy | 3551 Cassopolis St, Elkhart, IN 46514-6743 | 2008-04-25 |
| 1699854497 | Martin's Super Markets, Inc. | Pharmacy | 201 Concord Mall Dr, Elkhart, IN 46517-3109 | 2006-11-03 |
| 1679676399 | Hook Superx LLC | Pharmacy | 104 W Hively Ave, Elkhart, IN 46517-2113 | 2006-09-07 |
| 1871696211 | Hook Superx LLC | Pharmacy | 900 E Bristol St, Elkhart, IN 46514-3624 | 2006-09-07 |
| 1528161049 | Hook Superx LLC | Pharmacy | 1210 N Nappanee St, Elkhart, IN 46514-1732 | 2006-09-07 |
| 1710080239 | Hook Superx LLC | Pharmacy | 551 E Jackson Blvd, Elkhart, IN 46516-3528 | 2006-09-07 |
| 1043324031 | Charles H Stanton | Pharmacy | 306 S Us Highway 287, Elkhart, TX 75839-6726 | 2006-08-18 |
| 1205841335 | Walgreen Co | Pharmacy | 1400 Cassopolis St, Elkhart, IN 46514-3246 | 2006-07-29 |
| 1023059946 | Hook Superx Inc | Pharmacy | 1712 S Nappanee St, Elkhart, IN 46516-1705 | 2006-06-10 |
| Find all providers in ELKHART | ||||
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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.