KMART (NPI# 1891149241) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891149241 |
| Entity Type | Organization |
| Organization Name | KMART |
| Practice Address |
3801 Harmont Ave Ne Canton OH 44705-4331 |
| Practice Telephone | 3304532578 |
| Enumeration Date | 2016-04-21 |
| Last Update Date | 2016-04-21 |
| Authorized Official Name | MR. GEOFF GUIDER (PHARMACIST) |
| Authorized Official Telephone | 3306081204 |
| Is Organization Subpart | Y |
| Parent Organization Name | SEARS |
| Parent Organization TIN |
|
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 3-02-16757 | OH | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124456884 | Kmart | Point of Service | 613 First National St, Ironwood, MI 49938-3329 | 2013-10-16 |
| 1669704920 | Kmart | Pharmacy | 2716 Madison Ave, Indianapolis, IN 46225-2113 | 2010-02-10 |
| 1275734972 | Kmart | Pharmacist | 10501 Pines Blvd, Pembroke Pines, FL 33026 | 2007-05-30 |
| 1902358658 | Kmart | Pharmacist | 528 W Plank Rd, Altoona, PA 16602-2802 | 2016-10-28 |
| 1669922175 | Kmart | Pharmacy | 185 Upper River Rd, Gallipolis, OH 45631-1836 | 2016-10-07 |
| 1235583782 | Kmart | Pharmacist | 1801 W Alexis Rd, Toledo, OH 43613-2302 | 2016-04-21 |
| 1437503083 | Kmart | Pharmacist | 210 W Mercury Blvd, Hampton, VA 23669-2513 | 2016-04-20 |
| 1891149670 | Kmart | Pharmacy | 4715 Nine Mile Rd, Richmond, VA 23223-4908 | 2016-04-19 |
| 1609239136 | Kmart | Pharmacist | 1801 W Alexis Rd, Toledo, OH 43613-2302 | 2016-04-01 |
| 1700259728 | Kmart | Pharmacy | 4715 Nine Mile Rd, Richmond, VA 23223-4908 | 2015-11-12 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | KMART | 3333 Beverly Road, Hoffman Estates, IL 60179 |
| Virginia Business Entities | KMART APPAREL FASHIONS CORP. | 1209 Orange St, Wilmington, Delaware |
| Oklahoma Business Registrations | KMART APPAREL FASHIONS CORP. | Kmart, 7373 W. Side Ave, North Bergen, NJ 07047-0000 |
| Vermont Business Registrations | KMART APPAREL FASHIONS CORP. | 1209 Orange St., Wilmington, DE 19801 |
| Connecticut Business Registrations | KMART APPAREL FASHIONS CORP. | 7373 Westside Ave, North Bergen, NJ 07047 |
| Vermont Business Registrations | KMART CORPORATION | 3333 Beverly Rd., Hoffman Estates, IL 60179 |
| Oklahoma Business Registrations | KMART CORPORATION | 3100 W. Big Beaver Rd., Troy, MI 48084 |
| Washington State Corporations | KMART OF WASHINGTON LLC | 3333 Beverly Rd, Hoffman Estates, IL 60179 |
| Iowa Business Entities | KMART OPERATIONS LLC | 3333 Beverly Rd B2126b, Hoffman Estates, IL 60179 |
| Oregon Corporations, Companies and Business Names | KMART OPERATIONS LLC | 3333 Beverly Rd B2-101b, Hoffman Estates, IL 60179 |
| Street Address |
3801 HARMONT AVE NE |
| City | CANTON |
| State | OH |
| Zip Code | 44705-4331 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093047227 | James Robert Porter | Pharmacist | 3801 Harmont Ave Ne, Canton, OH 44705-4331 | 2010-02-15 |
| 1104275023 | Robert Marquardt IIi | Pharmacist | 3801 Harmont Ave Ne, Canton, OH 44705-4331 | 2016-06-10 |
| 1780615849 | K Mart Corp | Pharmacy | 3801 Harmont Ave Ne, Canton, OH 44705-4331 | 2006-07-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609395623 | Catherine Dana Tavares | Registered Nurse | 5321 Johnnycake Ridge Ne, Canton, OH 44705 | 2017-09-11 |
| 1790168706 | Vicki T Perrin | Home Health Aide | 3033 Endrow Ave Ne, Canton, OH 44705 | 2015-07-08 |
| 1679066542 | Atlantic Dme LLC | Durable Medical Equipment & Medical Supplies | 3501 Lesh St Ne, Canton, OH 44705 | 2018-06-14 |
| 1982262432 | Ciara A Davenport | Nurse's Aide | 809 Gibbs Ave Ne, Canton, OH 44705-1009 | 2019-05-30 |
| 1952790594 | Ivory Hollamon | Home Health Aide | 1209 Lippert Rd Ne, Canton, OH 44705-1019 | 2015-01-20 |
| 1003842196 | Lana May Butcher | Home Health Aide | 1219 Lippert Rd Ne, Canton, OH 44705-1019 | 2006-06-23 |
| 1124628896 | Asia Annette Everett | Home Health Aide | 918 Rowland Ave Ne, Canton, OH 44705-1064 | 2020-10-30 |
| 1396196267 | Pennie Lynn Mathewson | Student in an Organized Health Care Education/Training Program | 1309 Lawrence Rd Ne, Canton, OH 44705-1102 | 2016-06-22 |
| 1043861982 | Ravon L. Wise | Home Health Aide | 1130 12th St Ne, Canton, OH 44705-1120 | 2019-09-23 |
| 1518412360 | Angels In Mission | In Home Supportive Care | 1043 Rowland Ave Ne, Canton, OH 44705-1166 | 2016-08-22 |
| Find all providers in zip 44705 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437750551 | Anamiben R Patel | Pharmacist | 45555 Michigan Ave, Canton, MI 48188-2388 | 2020-11-04 |
| 1467084343 | Syed Ashraf Ali Shah | Pharmacist | 385 Westbourne Ct, Canton, MI 48188-4718 | 2020-02-07 |
| 1427680503 | Gracy Mathai-mathews | Pharmacist | 770 Pheasant Woods Dr, Canton, MI 48188-5224 | 2020-02-06 |
| 1962059378 | Catherine Lynn Denner | Pharmacist | 330 Oak Hill Ln, Canton, GA 30115-5433 | 2019-08-20 |
| 1427601806 | Tarek Mazloum | Pharmacist | 3815 Herbey St, Canton, MI 48188-2421 | 2019-07-24 |
| 1013473925 | Yen Do Ruiz | Pharmacist | 41460 Haggerty Circle South, Canton, MI 48188 | 2019-02-15 |
| 1063978260 | Jordan Richard Wanner | Pharmacist | 4615 Middlebranch Ave Ne, Canton, OH 44705-2960 | 2019-02-13 |
| 1861972333 | Brittany Carin Yu | Pharmacist | 2512 Tuscarawas St W, Canton, OH 44708-4702 | 2018-08-15 |
| 1598256364 | Austin Tull | Pharmacist | 2260 Holly Springs Pkwy Ste 180, Canton, GA 30115-9580 | 2018-05-28 |
| 1518491513 | Jerry Sherwin Vidis | Pharmacist | 41092 Northwind Dr, Canton, MI 48188-3115 | 2017-04-17 |
| Find all providers in CANTON | ||||
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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.