KMART OF MICHIGAN INC (NPI# 1801827886) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801827886 |
| Entity Type | Organization |
| Organization Name | KMART OF MICHIGAN INC |
| Other Organization Name | KMART PHARMACY9814 |
| Practice Address |
19990 Telegraph Rd Detroit MI 48219-1047 |
| Mailing Address |
3333 Beverly Rd Ac 367 B Hoffman Estates IL 60179-0001 |
| Practice Telephone | 3135378038 |
| Practice Fax Number | 3135378044 |
| Mailing Telephone | 8472864089 |
| Mailing Fax Number | 8472861603 |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2013-08-06 |
| 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 |
5301004903 | MI | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2041104 | 01 | |
| MI | 2320036 | 05 |
| Other Name | Type Code |
|---|---|
| KMART PHARMACY9814 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114353919 | Kmart of Michigan Inc | Pharmacy | 2425 S I 75 Business Loop, Grayling, MI 49738-2042 | 2013-09-25 |
| 1609984095 | Kmart of Michigan Inc | Pharmacy | 1151 S Otsego Ave # A, Gaylord, MI 49735-1789 | 2006-08-27 |
| 1760413751 | Kmart of Michigan Inc | Pharmacy | 2500 E M21, Corunna, MI 48817 | 2006-07-06 |
| 1700817780 | Kmart of Michigan Inc | Pharmacy | 19800 West Rd, Woodhaven, MI 48183-3319 | 2006-07-06 |
| 1609807692 | Kmart of Michigan Inc | Pharmacy | 6730 River Rd, Marine City, MI 48039-2284 | 2006-07-06 |
| 1538190517 | Kmart of Michigan Inc | Pharmacy | 100 E Maple Rd, Troy, MI 48083-2714 | 2006-07-06 |
| 1457382434 | Kmart of Michigan Inc | Pharmacy | 215 N Maple Rd, Ann Arbor, MI 48103-2823 | 2006-07-06 |
| 1538190525 | Kmart of Michigan Inc | Pharmacy | 710 Chicago Dr, Holland, MI 49423-3074 | 2006-07-06 |
| 1750312740 | Kmart of Michigan Inc | Pharmacy | 17580 Frazho Rd, Roseville, MI 48066-3829 | 2006-07-06 |
| 1336170323 | Kmart of Michigan Inc | Pharmacy | 2948 S State Rd, Ionia, MI 48846-9475 | 2006-07-06 |
| Street Address |
19990 TELEGRAPH RD |
| City | DETROIT |
| State | MI |
| Zip Code | 48219-1047 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073845244 | Leo P Gat | Pharmacist | 19990 Telegraph Rd, Detroit, MI 48219-1047 | 2010-02-12 |
| 1023365590 | Tanu Jain | Pharmacist | 19990 Telegraph Rd, Detroit, MI 48219-1047 | 2012-08-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891396008 | Betty Jean Fairchild-el | Home Health Aide | 20018 Norhtrop, Detroit, MI 48219 | 2020-11-04 |
| 1134787633 | Behavioral Health Professionals, Inc | Family Medicine | 19750 Burt Road, Detroit, MI 48219 | 2019-05-31 |
| 1255997755 | Shvaughn Laniece Nunley | Social Worker | 18422 W Mcnichols Rd, Detroit, MI 48219 | 2019-05-10 |
| 1770081168 | D & D Enterprise Group LLC | Durable Medical Equipment & Medical Supplies | 17405 Lahser, 202, Detroit, MI 48219 | 2018-01-31 |
| 1972011369 | Fibers of The Family LLC | Home Health | 16800 Edinborough Rd, Detroit, MI 48219 | 2018-01-19 |
| 1871049684 | Monique Jackson | Occupational Therapist | 21630 Jessel Ave, Detroit, MI 48219 | 2016-08-31 |
| 1114379773 | Audrey Hopkins | Licensed Practical Nurse | 20277 Redfren, Detroit, MI 48219 | 2016-07-07 |
| 1649628785 | Erin Bianco | Social Worker | 17321 Telegraph Rd., Detroit, MI 48219 | 2016-05-31 |
| 1144674664 | Lucinda Galmon-wallace | Technician, Other | 24424 Telegraph Road, Detroit, MI 48219 | 2016-04-21 |
| 1598120925 | Faith's Place LLC | Psychiatric Residential Treatment Facility | 16725 Blackstone Street, Detroit, MI 48219 | 2015-12-30 |
| Find all providers in zip 48219 | ||||
| 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] |
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| 1023616554 | Henry Ford Health System | Pharmacy | 2800 W Grand Blvd, Detroit, MI 48208 | 2020-10-16 |
| 1487269122 | Canfield Pharmacy LLC | Pharmacy | 4673 Conner St, Detroit, MI 48215-2028 | 2020-09-10 |
| 1912523986 | Gratiot Seven Pharmacy, LLC | Pharmacy | 12740 Gratiot Ave Ste 100, Detroit, MI 48205-3944 | 2020-06-24 |
| 1396361366 | Grand Greenfield Pharmacy, LLC | Pharmacy | 14661 Greenfield Rd Ste B, Detroit, MI 48227-2231 | 2020-06-24 |
| 1114556859 | Buena Salud LLC | Pharmacy | 7607 W Vernor Hwy, Detroit, MI 48209-1513 | 2020-04-04 |
| 1932737210 | West Park Pharmacy LLC | Pharmacy | 16240 W Warren Ave, Detroit, MI 48228 | 2020-03-31 |
| 1952938516 | Sinai Medical Pharmacy, LLC | Pharmacy | 16841 Schaefer Hwy, Detroit, MI 48235-4271 | 2020-03-24 |
| 1881231991 | Six Mile Medical Pharmacy, LLC | Pharmacy | 10420 W Mcnichols Rd Ste A, Detroit, MI 48221-2356 | 2019-12-08 |
| 1215570791 | Goshen Pharmacy LLC | Pharmacy | 16800 Greenfield Rd Unit B2, Detroit, MI 48235-3703 | 2019-10-28 |
| Find all providers in DETROIT | ||||
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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.