TRANSFORM KM LLC (NPI# 1528099645) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528099645 |
| Entity Type | Organization |
| Organization Name | TRANSFORM KM LLC |
| Other Organization Name | KMART PHARMACY #3725 |
| Practice Address |
1702 Freedom Blvd Freedom CA 95019-3025 |
| Mailing Address |
3333 Beverly Rd # Bc260a Hoffman Estates IL 60179-0001 |
| Practice Telephone | 8317289324 |
| Practice Fax Number | 8473962682 |
| Mailing Telephone | 8472864089 |
| Mailing Fax Number | 8477471553 |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2020-09-21 |
| Authorized Official Name | JENNIFER SPEARES LEHMAN (DVP OF PHARMACY) |
| Authorized Official Telephone | 8472865116 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
PHY39321 | CA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | PHA393210 | 05 | |
| CA | MEDICARE NSC | 7748430001 | 01 |
| CA | MEDICARE IMU | PHC150 | 01 |
| Other Name | Type Code |
|---|---|
| KMART PHARMACY #3725 | Doing Business As Name - Organization |
| KMART PHARMACY3725 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295041341 | Transform Km LLC | Pharmacy | 3333 Beverly Rd # Bc260a, Hoffman Estates, IL 60179-0001 | 2010-08-27 |
| 1396947248 | Transform Km LLC | Durable Medical Equipment & Medical Supplies | 250 W 34th St, New York, NY 10119-2152 | 2007-06-04 |
| 1700817772 | Transform Km LLC | Durable Medical Equipment & Medical Supplies | 18 Mark Plz, Kingston, PA 18704-3104 | 2006-07-06 |
| 1295766285 | Transform Km LLC | Durable Medical Equipment & Medical Supplies | 1 K Mart Plz, Greenville, SC 29605-4442 | 2006-07-06 |
| 1134150287 | Transform Km LLC | Durable Medical Equipment & Medical Supplies | 1815 21st St, Lewiston, ID 83501-4103 | 2006-07-06 |
| 1659302636 | Transform Km LLC | Durable Medical Equipment & Medical Supplies | 328 Ennis Ln, Towanda, PA 18848-9212 | 2006-07-06 |
| 1225069362 | Transform Km LLC | Durable Medical Equipment & Medical Supplies | 4100 52nd St, Kenosha, WI 53144-3900 | 2006-07-06 |
| 1649201781 | Transform Km LLC | Durable Medical Equipment & Medical Supplies | 770 Broadway, New York, NY 10003-9522 | 2006-07-06 |
| 1053342030 | Transform Km LLC | Pharmacy | Pr 149 Y 584, Plaza Juana Diaz, Juana Diaz, PR 00795 | 2006-07-06 |
| 1699706689 | Transform Km LLC | Durable Medical Equipment & Medical Supplies | Pr 2 Km 29.7, Centro Gran Caribe 16 II, Vega Alta, PR 00692 | 2006-07-06 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | TRANSFORM KM LLC | 3333 Beverly Rd, Hoffman Estates, IL 60179 |
| Washington State Corporations | TRANSFORM KM LLC | 3333 Beverly Road, Hoffman Estates, IL 60179 |
| New York State Corporations | TRANSFORM KM LLC | 28 Liberty Street, New York, New York 10005 |
| Iowa Business Entities | TRANSFORM KM LLC | 1170 Kane Concourse, Suite 200, Bay Harbor Islands, FL 33154 |
| Virginia Business Entities | Transform KM LLC | 3333 Beverly Rd, Hoffman Estates, Illinois 60179-0001 |
| Connecticut Business Registrations | TRANSFORM KM LLC | 3333 Beverly Road, Hoffman Estates, IL 60179 |
| Colorado Business Entities | Transform KM LLC | 5407 Trillium Boulevard, Suite B120, Hoffman Estates, IL 60192 |
| Street Address |
1702 FREEDOM BLVD |
| City | FREEDOM |
| State | CA |
| Zip Code | 95019-3025 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144765371 | Ai-huong Do | Pharmacist | 1702 Freedom Blvd, Freedom, CA 95019-3025 | 2016-12-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649757428 | J. B. Physical Therapy, Inc. | Physical Therapist | 212 Green Valley Road, Freedom, CA 95019 | 2018-07-24 |
| 1639514441 | Isamar Baeza | Counselor | 2716 Freedom Blvd., Freedom, CA 95019 | 2013-05-07 |
| 1174891386 | Lisa Patrice Hamil | Pharmacist | 1810 Freedom Blvd., Freedom, CA 95019 | 2011-12-02 |
| 1346363710 | Chad Truong | Dentist | 2016 Freedom Boulevard, Freedom, CA 95019 | 2007-04-09 |
| 1962539585 | Frederick Wen Kang Chen | Internal Medicine | 243 Green Valley Rd Suite #e, Freedom, CA 95019 | 2007-02-28 |
| 1538277819 | Jacqueline Morris-lopez | Physician Assistant | 108 Green Valley Rd, Freedom, CA 95019 | 2006-08-28 |
| 1912979725 | Angela Molina | Anesthesiology | 160 Green Valley Rd Ste 101, Freedom, CA 95019 | 2006-02-06 |
| 1194704973 | David A South Md & Kim M Albridge Md A Medical Corporation | Dermatology | 204 Green Valley Road, Freedom, CA 95019 | 2006-01-11 |
| 1699232108 | Kayhan Mashouf Dmd Inc | Dentist | 270 Green Valley Rd, Freedom, CA 95019 | 2019-02-21 |
| 1194215434 | Hai Phu Duong | Pharmacist | 1810 Freedom Blvd, Freedom, CA 95019 | 2018-05-11 |
| Find all providers in zip 95019 | ||||
| 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 |
|---|---|---|---|---|
| 1932578507 | Giant Eagle Inc | Pharmacy | 2500 Lovi Rd, Freedom, PA 15042-9398 | 2015-09-24 |
| 1700924180 | Valle Verde Pharmacy, Inc | Pharmacy | 240 Green Valley Rd, Freedom, CA 95019-3137 | 2007-02-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720689987 | Capsule San Diego LLC | Pharmacy | 1450 Columbia St Ste B, San Diego, CA 92101-3487 | 2020-11-04 |
| 1023618824 | Ingram's Pharmacy, LLC | Pharmacy | 1115 Union Ave Unit 147-1c, Bakersfield, CA 93307-1050 | 2020-10-29 |
| 1750981874 | Capsule San Francisco LLC | Pharmacy | 475 University Ave, Palo Alto, CA 94301-1814 | 2020-10-28 |
| 1447850623 | Sterling Hatteras LLC | Pharmacy | 916 E Cypress Ave Ste 300, Redding, CA 96002-1038 | 2020-10-28 |
| 1922608454 | Vanessa Ann Marie Rita Pitts | Pharmacy | 26365 Buccaneer Ln, Helendale, CA 92342-7739 | 2020-10-26 |
| 1205435971 | Rinaldi Pharmacy, Inc. | Pharmacy | 11237 Tampa Ave, Porter Ranch, CA 91326-1610 | 2020-10-22 |
| 1467051300 | San Dimas Wellness Pharmacy | Pharmacy | 830 W Arrow Hwy Ste 830b, San Dimas, CA 91773-2498 | 2020-10-21 |
| 1225636889 | Med-plus Pharmacy Inc | Pharmacy | 335 Lindbergh Ave, Livermore, CA 94551-9291 | 2020-10-15 |
| 1689271066 | Innova Pharmacy Iv | Pharmacy | 4815 Watt Ave Ste B101, North Highlands, CA 95660-5108 | 2020-10-08 |
| 1114524683 | Bear Valley Pharmacy | Pharmacy | 17003 Bear Valley Rd Ste B, Hesperia, CA 92345-1420 | 2020-10-07 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on TRANSFORM KM LLC.
| 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.