K MART CORP (NPI# 1891726949) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891726949 |
| Entity Type | Organization |
| Organization Name | K MART CORP |
| Other Organization Name | KMART PHARMACY3541 |
| Practice Address |
103 Oak Ave Menomonie WI 54751-1363 |
| Mailing Address |
3333 Beverly Rd Ac 367 B Hoffman Estates IL 60179-0001 |
| Practice Telephone | 7152356770 |
| Practice Fax Number | 7152353464 |
| 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 |
7015-42 | WI | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 33166500 | 05 | |
| PK | 2114958 | 01 |
| Other Name | Type Code |
|---|---|
| KMART PHARMACY3541 | 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 |
| Washington State Corporations | K MART CORPORATION | 3333 Beverly Rd, Hoffman Estates, IL 60179-0001 |
| Street Address |
103 OAK AVE |
| City | MENOMONIE |
| State | WI |
| Zip Code | 54751-1363 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184834137 | Brenda A Maloney | Pharmacist | 103 Oak Ave, Menomonie, WI 54751-1363 | 2007-05-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154840569 | Ashley Friedenfels | Physical Medicine & Rehabilitation | E4486 290th Avenue, Menomonie, WI 54751 | 2017-09-18 |
| 1215307814 | David Calvin Reimann | Hearing Instrument Specialist | E4584 483rd Avenue, Menomonie, WI 54751 | 2015-09-25 |
| 1790128627 | County of Dunn | Skilled Nursing Facility | 651 Howison Circle, Menominie, WI 54751 | 2013-04-10 |
| 1043653983 | County of Dunn | Skilled Nursing Facility | 658 Howison Circle, Menomonie, WI 54751 | 2013-04-10 |
| 1447519236 | Gentle Dental Care LLC | Dentist | 1813 Wilson St., Menomonie, WI 54751 | 2012-05-14 |
| 1386960193 | Kilimanjaro LLC | Non-emergency Medical Transport (VAN) | 1222 14th Ave E, Menomonie, WI 54751 | 2010-04-19 |
| 1275709180 | Dianne Marie Bennett | Counselor | 1916 2nd St W, Menomonie, WI 54751 | 2008-05-01 |
| 1417136201 | David Gary Hackbarth | Chiropractor | 3120 Schneider Ave E, Suite #5, Menomonie, WI 54751 | 2007-10-29 |
| 1306057336 | Tonia D. Behling | Dental Hygienist | 3375 Kothlow Ave., Suite 40, Menomonie, WI 54751 | 2007-05-24 |
| 1295956282 | Danny Roger Wood | Dentist | 1603 Stout Rd, Menomonie, WI 54751 | 2007-05-01 |
| Find all providers in zip 54751 | ||||
| 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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| 1851939037 | Ascension Wisconsin Pharmacy, Inc | Pharmacy | 10180 Washington Ave Ste 102, Mount Pleasant, WI 53177-1604 | 2019-12-18 |
| 1558906354 | Life Change Rx 4 LLC | Pharmacy | 6300 N 76th St Ste 246, Milwaukee, WI 53218-1208 | 2019-11-15 |
| 1285278978 | Life Change Rx 3 LLC | Pharmacy | 7115 W Capitol Dr, Milwaukee, WI 53216-2051 | 2019-11-05 |
| 1295377703 | Hayat Pharmacy 21 LLC. | Pharmacy | 2333 Northwestern Ave Ste 120, Racine, WI 53404-2520 | 2019-10-16 |
| 1487296737 | Xperience Pharmacy LLC | Pharmacy | 5715 W Appleton Ave, Milwaukee, WI 53210-2250 | 2019-10-08 |
| 1962053421 | Hayat Pharmacy 19 LLC | Pharmacy | 805 W. Layton Ave. Suite A, Milwaukee, WI 53221 | 2019-09-26 |
| 1275182925 | Walgreen Co | Pharmacy | 2265 N Mayfair Rd, Wauwatosa, WI 53226-2207 | 2019-09-05 |
| 1982257200 | Hayat Pharmacy 16 LLC | Pharmacy | 603 N 36th St, Milwaukee, WI 53208-3826 | 2019-07-17 |
| 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.