TRANSFORM KM OF MICHIGAN LLC (NPI# 1770514762) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770514762 |
| Entity Type | Organization |
| Organization Name | TRANSFORM KM OF MICHIGAN LLC |
| Other Organization Name | KMART PHARMACY3379 |
| Practice Address |
5100 Dixie Hwy Waterford MI 48329-1793 |
| Mailing Address |
3333 Beverly Rd # Bc260a Hoffman Estates IL 60179-0001 |
| Practice Telephone | 2486743183 |
| Practice Fax Number | 8473962608 |
| Mailing Telephone | 8472864089 |
| Mailing Fax Number | 8477471553 |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2019-05-14 |
| NPI Deactivation Date | 02/14/2019 |
| NPI Reactivation Date | 2019-05-14 |
| Authorized Official Name | JENNIFER SPEARES LEHMAN (HEAD 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 |
5301004926 | MI | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2041968 | 01 | |
| MI | 2532412 | 05 |
| Other Name | Type Code |
|---|---|
| KMART PHARMACY #3379 | Doing Business As Name - Organization |
| KMART PHARMACY3379 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679504666 | Transform Km of Michigan LLC | Durable Medical Equipment & Medical Supplies | 1101 7th Ave, Menominee, MI 49858-3130 | 2006-07-06 |
| 1346271335 | Transform Km of Michigan LLC | Durable Medical Equipment & Medical Supplies | 802 W State St, Hastings, MI 49058-1659 | 2006-07-06 |
| 1689605677 | Transform Km of Michigan LLC | Durable Medical Equipment & Medical Supplies | 1820 S Saginaw Rd, Midland, MI 48640-6837 | 2006-07-06 |
| 1366473340 | Transform Km of Michigan LLC | Durable Medical Equipment & Medical Supplies | 2095 Rawsonville Rd, Belleville, MI 48111-2219 | 2006-07-06 |
| 1073544060 | Transform Km of Michigan LLC | Durable Medical Equipment & Medical Supplies | 15861 W Michigan Ave, Marshall, MI 49068-9578 | 2006-07-06 |
| 1609807601 | Transform Km of Michigan LLC | Durable Medical Equipment & Medical Supplies | 5719 N Us Highway 23, Oscoda, MI 48750-8721 | 2006-07-06 |
| 1104170190 | Transform Km of Michigan LLC | Durable Medical Equipment & Medical Supplies | 3333 Beverly Rd, Bc 259 Aa, Hoffman Estates, IL 60179-0001 | 2012-10-30 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Iowa Business Entities | TRANSFORM KM OF MICHIGAN LLC | 1170 Kane Concourse, Suite 200, Bay Harbor Islands, FL 33154 |
| Street Address |
5100 DIXIE HWY |
| City | WATERFORD |
| State | MI |
| Zip Code | 48329-1793 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669422002 | Robert M. Meyers | Pharmacist | 5100 Dixie Hwy, Waterford, MI 48329-1713 | 2006-05-10 |
| 1194192278 | Julie Williamsom | Pharmacist | 5100 Dixie Hwy, Waterford, MI 48329-1713 | 2015-08-25 |
| 1932536018 | Adam Stanley Twarkowski | Pharmacist | 5100 Dixie Hwy, Waterford, MI 48329-1713 | 2013-10-03 |
| 1194152884 | Kailashben P Patel | Pharmacist | 5100 Dixie Hwy, Waterford, MI 48329-1713 | 2013-09-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386124139 | Melissa A Blake | Occupational Therapist | 3257 Whitfield Ct, Waterford, MI 48329 | 2018-08-20 |
| 1932699741 | Julianne Marie Fittonneville | Counselor | 4000 W Walton Blvd Ste A&b, Waterford, MI 48329 | 2018-05-16 |
| 1730615717 | Innovative Lifestyles, Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5490 Dixie Hwy, Suite 1, Waterford, MI 48329 | 2017-05-11 |
| 1841670502 | Kayla Brianne Dandino | Speech-Language Pathologist | 5601 Hatchery Rd., Waterford Township, MI 48329 | 2015-06-08 |
| 1093122400 | Caring 4 Loved Ones, Inc | Registered Nurse | 3549 Lakeshore Dr., Waterford, MI 48329 | 2014-07-17 |
| 1124448329 | Michael Alan Watson | Emergency Medicine | 5826 Dixie Hwy, Waterford Township, MI 48329 | 2014-04-27 |
| 1417263120 | Metro Imaging Center Plc | Dentist | 4664 W. Walton Blvd., Waterford, MI 48329 | 2010-08-19 |
| 1225278013 | S.e.t. Footcare, P.C. | Podiatrist | 4396-1 Dixie Hwy, Waterford, MI 48329 | 2009-03-06 |
| 1962556498 | Mark Andrew Laszlo | Dentist | 4624 Walton Blvd, Waterford, MI 48329 | 2007-01-22 |
| 1437211927 | Pankajini N Doshi | Pediatrics | 4299 Roseberry Ct, Waterford, MI 48329 | 2006-12-14 |
| Find all providers in zip 48329 | ||||
| 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 |
|---|---|---|---|---|
| 1518423631 | Gill Pharmacy Inc | Pharmacy | 12648 Bentley St, Waterford, CA 95386-9009 | 2019-02-13 |
| 1942708607 | Gary Jules Bango | Pharmacy | 155 Waterford Parkway N, Waterford, CT 06385-1208 | 2018-01-29 |
| 1003272436 | Lakeview Pharmacy, LLC | Pharmacy | 3901 Highland Rd Ste D2, Waterford, MI 48328-2162 | 2016-01-14 |
| 1841674868 | Noble Care Apothecary PC | Pharmacy | 7362 Highland Rd, Waterford, MI 48327-1508 | 2015-07-20 |
| 1861817975 | H & P Food Town Pharmacy Inc | Pharmacy | 7300 Highland Rd Ste A, Waterford, MI 48327-1508 | 2014-02-26 |
| 1275718686 | Genoa Healthcare, LLC | Pharmacy | 279 Summit Dr Ste 200, Waterford, MI 48328-3364 | 2008-01-03 |
| 1063524916 | Woodward Detroit Cvs, L.L.C. | Pharmacy | 4300 Dixie Hwy, Waterford, MI 48329-4070 | 2006-08-31 |
| 1447362371 | Woodward Detroit Cvs, L.L.C. | Pharmacy | 7960 Cooley Lake Rd, Waterford, MI 48327-4184 | 2006-08-31 |
| 1639709520 | Ravi Gandhi | Pharmacy | 12648 Bentley St, Waterford, CA 95386-9009 | 2020-01-20 |
| 1124413158 | Jwa Services Inc | Pharmacy | 92 Boston Post Rd, Waterford, CT 06385-2421 | 2015-04-07 |
| Find all providers in WATERFORD | ||||
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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.