KMART PHARMACY (NPI# 1477907954) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477907954 |
| Entity Type | Organization |
| Organization Name | KMART PHARMACY |
| Practice Address |
830 W Fulton St Waupaca WI 54981-1406 |
| Practice Telephone | 7152584285 |
| Enumeration Date | 2016-04-20 |
| Last Update Date | 2016-04-26 |
| Authorized Official Name | JENNIFER SPEARES (DIRECTOR) |
| Authorized Official Telephone | 8642970844 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 333600000X | Pharmacy | Suppliers |
| 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 |
| 1255787008 | Kmart Pharmacy | Case Management | 404 N Marine Corps Dr, Tamuning, GU 96913-4109 | 2016-05-11 |
| 1750735007 | Kmart Pharmacy | Pharmacy | 1308 W Walnut Ave, Dalton, GA 30720-3827 | 2016-04-22 |
| 1366896920 | Kmart Pharmacy | Pharmacy | 2520 Nicholasville Rd, Lexington, KY 40503-3384 | 2016-04-20 |
| Street Address |
830 W FULTON ST |
| City | WAUPACA |
| State | WI |
| Zip Code | 54981-1406 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083645139 | Transform Km LLC | Pharmacy | 830 W Fulton St, Waupaca, WI 54981-1406 | 2006-07-06 |
| 1235451188 | David Kempfert | Pharmacist | 830 W Fulton St, Waupaca, WI 54981-1406 | 2010-02-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366096141 | Renee Elizabeth Winn | Speech-Language Pathologist | 800 Riverside Drive Dr. 902 Building, Speech Therapy, Waupaca, WI 54981 | 2019-07-30 |
| 1891263216 | Stephanie Rice | Dental Hygienist | N4008 Morgan Dr, Waupaca, WI 54981 | 2018-11-03 |
| 1972092989 | Renew Physical Therapy and Wellness, LLC | Physical Therapist | N2919 County Road Qq, Waupaca, WI 54981 | 2018-05-04 |
| 1366942195 | Lanna Boyle | Physical Medicine & Rehabilitation | E1132 Hillcrest Dr, Waupaca, WI 54981 | 2018-02-19 |
| 1710333893 | Thedacare Medical Center - Waupaca, Inc. | General Acute Care Hospital | N2610 Wi 22, Waupaca, WI 54981 | 2016-05-09 |
| 1750743365 | Kimberly Marie Kraeger | Counselor | Waupaca County Dhhs, 811 Harding St, Waupaca, WI 54981 | 2016-03-23 |
| 1619211596 | Kari Anna Esbensen | Counselor | N2919 Cty Qq, Waupaca, WI 54981 | 2012-11-16 |
| 1396027629 | Roots Wholistic Health | Chiropractor | 717 Churchill St., Waupaca, WI 54981 | 2011-09-13 |
| 1629387006 | Barton Jerome Blum | General Practice | E1803 Melody Lane, Waupaca, WI 54981 | 2010-10-01 |
| 1710219357 | Anne Marie Collins-reed | Social Worker | 315 River Road, New London, WI 54981 | 2010-02-08 |
| Find all providers in zip 54981 | ||||
| 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 |
|---|---|---|---|---|
| 1083645139 | Transform Km LLC | Pharmacy | 830 W Fulton St, Waupaca, WI 54981-1406 | 2006-07-06 |
| 1083625586 | Stratton Drug Inc | Pharmacy | 107 N Main St, Waupaca, WI 54981-1542 | 2006-08-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497355002 | Long Life Pharmacy 2 LLC | Pharmacy | 1225 W Historic Mitchell St Ste 217, Milwaukee, WI 53204-3382 | 2020-11-01 |
| 1710527783 | Sage Specialty Pharmacy Inc. | Pharmacy | 4001 N. Oakland Ave, Shorewood, WI 53211 | 2020-01-08 |
| 1790333623 | Froedtert Health Pharmacy LLC | Pharmacy | 9200 W Wisconsin Ave Ste 200w, Milwaukee, WI 53226-3522 | 2019-09-04 |
| 1225686405 | Froedtert Health Pharmacy LLC | Pharmacy | 9200 W Wisconsin Ave Ste 200c, Milwaukee, WI 53226-3522 | 2019-08-30 |
| 1134777337 | Froedtert Health Pharmacy LLC | Pharmacy | 11430 N Port Washington Rd Ste 103, Mequon, WI 53092-3414 | 2019-08-30 |
| 1619524766 | University Rx LLC | Pharmacy | 133 E College Ave, Appleton, WI 54911 | 2019-08-23 |
| 1053967026 | Accurabenefits, LLC | Pharmacy | 2413 Woodland Ter, Neenah, WI 54956-4824 | 2019-08-14 |
| 1184276917 | St. Clare Health Mission Pharmacy | Pharmacy | 916 Ferry St, La Crosse, WI 54601-4717 | 2019-07-11 |
| 1851851141 | Dean Retail Services, Inc. | Pharmacy | 740 Reena Ave Ste 300, Fort Atkinson, WI 53538-3145 | 2019-03-22 |
| 1093287237 | Del Mar Pharmacy Sc | Pharmacy | 1000 S Cesar E Chavez Dr, Milwaukee, WI 53204-2203 | 2018-12-28 |
| Find all providers with the same taxonomy | ||||
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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.