KMART PHRAMACY (NPI# 1891159976) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891159976 |
| Entity Type | Organization |
| Organization Name | KMART PHRAMACY |
| Practice Address |
3415 N Elizabeth St Pueblo CO 81008-1156 |
| Mailing Address |
206 S Golfwood Dr W Pueblo CO 81007-3674 |
| Practice Telephone | 7195450707 |
| Practice Fax Number | 8473962896 |
| Mailing Telephone | 7195680470 |
| Mailing Fax Number | 8473692896 |
| Enumeration Date | 2016-04-05 |
| Last Update Date | 2016-04-05 |
| Authorized Official Name | MR. SEYED ABOTALEB ALAVI (PHARMACIST) |
| Authorized Official Telephone | 7195680470 |
| Authorized Official Credential | RPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 305S00000X | Point of Service | 0013355 | CO | Managed Care Organizations |
| Street Address |
3415 N ELIZABETH ST |
| City | PUEBLO |
| State | CO |
| Zip Code | 81008-1156 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770514887 | Transform Km LLC | Pharmacy | 3415 N Elizabeth St, Pueblo, CO 81008-1156 | 2006-07-06 |
| 1508198722 | Dale A Reber | Pharmacist | 3415 N Elizabeth St, Pueblo, CO 81008-1156 | 2010-02-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164058913 | Healthone Clinic Services - Oncology Hematology LLC | Internal Medicine | 3678 Parker Blvd, Pueblo, CO 81008 | 2020-03-12 |
| 1073026423 | Carmel Community Living Corporation | Respite Care | 2003 Northmoor Terrace, Suite 100, Pueblo, CO 81008 | 2017-11-08 |
| 1568987121 | Hannah Vivian Roadruck | Pharmacist | 4200 Dillon Dr., Pueblo, CO 81008 | 2017-08-04 |
| 1184170425 | Brett Burana | Dentist | 729 Us-50, Pueblo, CO 81008 | 2016-08-28 |
| 1760832885 | Irby Dental Cottage | Dental Hygienist | 2099 West St # 50, Suite 180, Pueblo, CO 81008 | 2016-06-20 |
| 1649624362 | Curley Peak Dentistry Pllc | Dentist | 1640 W Fortino Blvd, Pueblo, CO 81008 | 2016-04-19 |
| 1336507847 | Kyle Tipton | Nurse Anesthetist, Certified Registered | 4741 Eagleridge Circle, 206, Pueblo, CO 81008 | 2016-01-29 |
| 1407211931 | Center At Park West, LLC | Skilled Nursing Facility | 3727 Parker Blvd., Pueblo, CO 81008 | 2015-12-29 |
| 1417327461 | Nicole Betts | Registered Nurse | 1310 Fortino Blvd Ste D, Pueblo, CO 81008 | 2015-10-02 |
| 1437578028 | Pueblo Modern Dentistry and Orthodontics, LLP | Dentist | 727 Us Hwy 50 West, Pueblo, CO 81008 | 2014-04-10 |
| Find all providers in zip 81008 | ||||
| Taxonomy Code | 305S00000X |
| Grouping | Managed Care Organizations |
| Classification | Point of Service |
| This product may also be called an open-ended HMO and offers a transition product incorporating features of both HMOs and PPOs. Beneficiaries are enrolled in an HMO but have the option to go outside the networks for an additional cost. |
| Notes: Source: "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 62 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841829520 | 4 Winds / 5 Elements Counseling and Healing Arts Pllc | Point of Service | 2201 Kipling St Ste 204, Lakewood, CO 80215-1545 | 2020-04-05 |
| 1952953515 | Mary Brown | Point of Service | 2673 Del Mar Dr, Grand Junction, CO 81506-1721 | 2019-07-14 |
| 1285168583 | State of Colorado | Point of Service | 1575 Sherman Street, Cdhs, Denver, CO 80203 | 2017-04-13 |
| 1902339963 | Hti2, LLC Dba Pearle Vision Loveland | Point of Service | 1391 Sculptor Dr., Loveland, CO 80537 | 2017-04-06 |
| 1386196665 | Colorado Department of Corrections | Point of Service | 49030 State Hwy 71, Limon, CO 80826-0001 | 2016-11-02 |
| 1861941130 | Erx Consulting | Point of Service | 6133 E Mineral Dr, Centennial, CO 80112-3009 | 2016-09-28 |
| 1104287176 | Allfocus Holding LLC | Point of Service | 11015 Hill Gail Ct, Parker, CO 80138-7246 | 2016-03-17 |
| 1013377274 | Colorado Assisted Living Homes | Point of Service | 5596 W Indore Dr, Littleton, CO 80128-7030 | 2016-03-02 |
| 1104286376 | Colorado Assisted Living Homes | Point of Service | 7456 S Kendall Blvd, Littleton, CO 80128-4682 | 2016-03-02 |
| 1487014916 | Senior Living At The Pinery LLC | Point of Service | 6875 N Windview Cir, Parker, CO 80134-6337 | 2016-02-25 |
| Find all providers with the same taxonomy | ||||
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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.