K MART CORP (NPI# 1578594537) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578594537 |
| Entity Type | Organization |
| Organization Name | K MART CORP |
| Other Organization Name | KMART PHARMACY4067 |
| Practice Address |
7530 S Anthony Blvd Fort Wayne IN 46816 |
| Mailing Address |
3333 Beverly Rd Ac 367 B Hoffman Estates IL 60179-0001 |
| Practice Telephone | 2604472544 |
| Practice Fax Number | 2604476245 |
| Mailing Telephone | 8472864089 |
| Mailing Fax Number | 8472861603 |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2013-08-08 |
| Authorized Official Name | ELIZABETH ZANDER (DIRECTOR MANAGED CARE) |
| Authorized Official Telephone | 8472867661 |
| 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 |
60005799A | IN | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 100293660A | 05 | |
| PK | 2026268 | 01 |
| Other Name | Type Code |
|---|---|
| KMART PHARMACY4067 | 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 |
7530 S ANTHONY BLVD |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46816 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841769270 | Brian Bernard Conaway | Occupational Therapist | 7125 S Hanna St, Fort Wayne, IN 46816 | 2018-11-14 |
| 1073006938 | Fort Wayne Aal Lp | Assisted Living Facility | 7125 S Hanna Street, Fort Wayne, IN 46816 | 2018-06-14 |
| 1811282064 | Connisha Sanders | Occupational Therapy Assistant | 8309, Bridgeway Cir Apt 3a, Fort Wayne, IN 46816 | 2011-06-16 |
| 1144239609 | James J Bohlin | Dentist | 7524 South Anthony Blvd., Fort Wayne, IN 46816 | 2006-08-05 |
| 1720540503 | Jill Ann Woodward | Occupational Therapy Assistant | 7125 S Hanna St, Fort Wayne, IN 46816 | 2019-04-02 |
| 1639163884 | Patrice C Ellingson | Optometrist | 1515 E Paulding Rd, Fort Wayne, IN 46816 | 2005-09-02 |
| 1114140134 | Jon D. Ingleman | Dentist | 223 E Tillman Rd, Fort Wayne, IN 46816-1016 | 2007-04-10 |
| 1538189063 | Yoder/rahrig Family Dentistry | Dentist | 333 E Tillman Rd, Fort Wayne, IN 46816-1017 | 2006-07-20 |
| 1619997137 | Gerald J. Rahrig | Dentist | 333 E Tillman Rd, Fort Wayne, IN 46816-1017 | 2006-07-20 |
| 1780235374 | Kathryn Welch | Dentist | 223 E Tillman Rd, Fort Wayne, IN 46816-1079 | 2019-09-25 |
| Find all providers in zip 46816 | ||||
| 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 |
|---|---|---|---|---|
| 1659576395 | Kroger Limited Partnership I | Pharmacy | 5300 Decatur Rd, Fort Wayne, IN 46806-3058 | 2007-06-20 |
| 1427253756 | Kroger Limited Partnership I | Pharmacy | 7008 Bluffton Rd, Fort Wayne, IN 46809-2706 | 2007-06-18 |
| 1689879074 | Kroger Limited Partnership I | Pharmacy | 1125 W State Blvd, Fort Wayne, IN 46808-3185 | 2007-06-18 |
| 1578768974 | Kroger Limited Partnership I | Pharmacy | 6310 E State Blvd, Fort Wayne, IN 46815-7023 | 2007-06-18 |
| 1679778989 | Kroger Limited Partnership I | Pharmacy | 10230 Chestnut Plaza Dr, Fort Wayne, IN 46814-8970 | 2007-06-18 |
| 1275737355 | Kroger Limited Partnership I | Pharmacy | 710 E Dupont Rd, Fort Wayne, IN 46825-2056 | 2007-06-13 |
| 1790989879 | Kroger Limited Partnership I | Pharmacy | 4120 N Clinton St, Fort Wayne, IN 46805-1230 | 2007-06-13 |
| 1043414121 | Kroser Limited Phartnership I | Pharmacy | 3105 N Anthony Blvd, Fort Wayne, IN 46805-2227 | 2007-06-13 |
| 1275636961 | Hook Superx LLC | Pharmacy | 2811 Getz Rd, Fort Wayne, IN 46804-3064 | 2006-09-07 |
| 1588767297 | Hook Superx LLC | Pharmacy | 7330 Lima Rd, Fort Wayne, IN 46818-1130 | 2006-09-07 |
| Find all providers in FORT WAYNE | ||||
| City | FORT WAYNE |
| Zip Code | 46816 |
Please comment or provide details below to improve the information on K MART CORP.
| 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.