KMART PHARMACY (NPI# 1255787008) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255787008 |
| Entity Type | Organization |
| Organization Name | KMART PHARMACY |
| Practice Address |
404 N Marine Corps Dr Tamuning GU 96913-4109 |
| Practice Telephone | 6714864169 |
| Practice Fax Number | 6716497841 |
| Enumeration Date | 2016-05-11 |
| Last Update Date | 2016-05-11 |
| Authorized Official Name | DR. ROBERT GOODHUE JR. (PHARMACY DISTRICT MANAGER) |
| Authorized Official Telephone | 6028722218 |
| Authorized Official Credential | PHARMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251B00000X | Case Management | PH0217 | GU | Agencies |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073067278 | Kmart Pharmacy | Pharmacy | 161 Big Elk Mall, Elkton, MD 21921-5912 | 2016-08-05 |
| 1104270040 | Kmart Pharmacy | Pharmacist | 2965 Hemingway Lane, Lexington, KY 40513-0000 | 2016-04-18 |
| 1194188953 | Kmart Pharmacy | Pharmacist | 1801 W Alexis Rd, Toledo, OH 43613-2302 | 2016-03-30 |
| 1619386901 | Kmart Pharmacy | Pharmacy | 4000 East 2nd, Casper, WY 82609 | 2014-08-12 |
| 1386057677 | Kmart Pharmacy | Pharmacy | 1284 Brice Rd, Reynoldsburg, OH 43068-2311 | 2014-06-04 |
| 1104236843 | Kmart Pharmacy | Pharmacy | 1205 E Pine St, Deming, NM 88030-7038 | 2014-05-03 |
| 1588108757 | Kmart Pharmacy | Clinic/Center | 2600 Lincoln Way E, Massillon, OH 44646-5055 | 2016-12-07 |
| 1750735007 | Kmart Pharmacy | Pharmacy | 1308 W Walnut Ave, Dalton, GA 30720-3827 | 2016-04-22 |
| 1477907954 | Kmart Pharmacy | Pharmacy | 830 W Fulton St, Waupaca, WI 54981-1406 | 2016-04-20 |
| 1366896920 | Kmart Pharmacy | Pharmacy | 2520 Nicholasville Rd, Lexington, KY 40503-3384 | 2016-04-20 |
| Street Address |
404 N MARINE CORPS DR |
| City | TAMUNING |
| State | GU |
| Zip Code | 96913-4109 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881625937 | Transform Km LLC | Durable Medical Equipment & Medical Supplies | 404 N Marine Corps Dr, Tamuning, GU 96913-4109 | 2006-07-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871126219 | Hannah Marie Sabo Laney | Behavior Technician | 212 Farenholt Ave., Tamuning, GU 96913 | 2020-02-13 |
| 1720618499 | Jacquelin Gouniai | Counselor | 121 North Sabana Drive Detcha Court, Barrigada Heights, GU 96913 | 2020-01-22 |
| 1205475753 | Gabriela Victoria Perez | Behavior Technician | 212 Farenholt Ave, Tamuning, GU 96913 | 2020-01-02 |
| 1073154944 | Quenie-mei Tuliao Fisher | Pharmacist | 790 Governor Carlos Camacho Rd, Tamuning, GU 96913 | 2019-10-02 |
| 1366090698 | Elizabeth Rabon | Technician | 251 Carnation Ave, Mangilao, GU 96913 | 2019-08-29 |
| 1467000299 | Yun Ming Lin | Pharmacist | 850 Gov. Carlos Camacho Street, Tamuning, GU 96913 | 2019-08-26 |
| 1902465354 | Anthony John Litwinchuk Jr. | Audiologist | Usnh Guam - Audiology Department, Bldg #50 Farenholt Ave, Agana Heights, GU 96913 | 2019-06-10 |
| 1124580600 | Khkn Corporation | Acupuncturist | 817 N Marine Corps Dr 109, Tamuning, GU 96913 | 2019-04-03 |
| 1700346541 | Amc Mental Health, LLC | Marriage & Family Therapist | 263 Vietnam Veterans Highway, Mangilao, GU 96913 | 2019-03-20 |
| 1295292365 | Jhaymie Lynn Salarzon Bejerana | Behavior Technician | Building 1350 #216, Upper Tumon, GU 96913 | 2019-02-26 |
| Find all providers in zip 96913 | ||||
| Taxonomy Code | 251B00000X |
| Grouping | Agencies |
| Classification | Case Management |
| An organization that is responsible for providing case management services. The agency provides services which assist an individual in gaining access to needed medical, social, educational, and/or other services. Case management services may be used to locate, coordinate, and monitor necessary appropriate services. It may be used to encourage the use of cost-effective medical care by referrals to appropriate providers and to discourage over utilization of costly services. Case management may also serve to provide necessary coordination of non-medical services such as vocational rehabilitation, education, employment, when the services provided enable the individual to function at the highest level. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891048062 | Sanctuary | Case Management | 406 Maimai St, Chalan Pago, GU 96910-5669 | 2012-10-24 |
| 1750648283 | Elim Pacific Ministries | Case Management | 556 E Marine Corps Dr, Hagatna, GU 96910-5186 | 2012-04-23 |
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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.