K MART CORP (NPI# 1902837990) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902837990 |
| Entity Type | Organization |
| Organization Name | K MART CORP |
| Other Organization Name | KMART PHARMACY7555 |
| Practice Address |
1610 Church St Ste U Conway SC 29526-2932 |
| Mailing Address |
3333 Beverly Rd Ac 367 B Hoffman Estates IL 60179-0001 |
| Practice Telephone | 8432480505 |
| Practice Fax Number | 8433810961 |
| Mailing Telephone | 8472864089 |
| Mailing Fax Number | 8472861603 |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2015-02-04 |
| Authorized Official Name | JENNIFER SPEARES (DIR. OF COMPLIANCE AND ADMIN.) |
| Authorized Official Telephone | 8472865116 |
| 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 |
50003243 | SC | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2090777 | 01 | |
| SC | 732432 | 05 |
| Other Name | Type Code |
|---|---|
| KMART PHARMACY7555 | 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 |
1610 CHURCH ST STE U |
| City | CONWAY |
| State | SC |
| Zip Code | 29526-2932 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437409547 | Karissa Marie Proctor | Pharmacist | 1610 Church St Ste U, Conway, SC 29526-2932 | 2012-09-17 |
| 1497200364 | Debra Lynn Anderson | Pharmacist | 1610 Church St Ste U, Conway, SC 29526-2932 | 2016-08-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457975237 | Terri L Champion | Massage Therapist | 172 Waccamaw Medical Park Court, Conway, SC 29526 | 2020-06-08 |
| 1689204398 | Alayna Defalco | Clinical Exercise Physiologist | 1320 501 Business, Unit E, Conway, SC 29526 | 2020-01-22 |
| 1124672662 | Proxsys Rx - Sc, LLC | Pharmacy | 300 Singelton Ridge Road, Conway, SC 29526 | 2019-08-01 |
| 1598227431 | Surgery Center of Conway Inc | Clinic/Center | 1405 Main Street, Conway, SC 29526 | 2019-04-01 |
| 1801374962 | Trevor James Hess | Specialist/Technologist | 905 One Landon Loop, Conway, SC 29526 | 2018-08-01 |
| 1851800817 | Katherine Ann Nimphius | Behavioral Analyst | 105 Timberline Dr, Conway, SC 29526 | 2017-09-21 |
| 1922544253 | William Houck | Specialist/Technologist | 925 One Landon Loop, Conway, SC 29526 | 2017-01-10 |
| 1952857278 | Courtney Jeanette Smith | Counselor | 164 Waccamaw Medical Park Dr., Conway, SC 29526 | 2016-08-28 |
| 1336502632 | Jebediah S. Christy, D.d.s - Conway, Pllc | Dentist | 2756 Church St, Conway, SC 29526 | 2016-04-04 |
| 1447615208 | Abl Enterprises, LLC | Optometrist | 113 Citadel Drive, Conway, SC 29526 | 2015-12-22 |
| Find all providers in zip 29526 | ||||
| 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 |
|---|---|---|---|---|
| 1124672662 | Proxsys Rx - Sc, LLC | Pharmacy | 300 Singelton Ridge Road, Conway, SC 29526 | 2019-08-01 |
| 1023466281 | Sam's Club Pharmacy | Pharmacy | 1850 S Donaghey Ave, Conway, AR 72034-8659 | 2016-05-28 |
| 1588077283 | Cornerstone Pharmacy Conway, LLC | Pharmacy | 815 Hogan Ln Ste 10, Conway, AR 72034-7959 | 2014-06-10 |
| 1659619120 | Conway Medcare Pharmacy, LLC | Pharmacy | 2521 College Ave, Conway, AR 72034-6135 | 2013-01-17 |
| 1104186212 | Southside Pharmacy LLC | Pharmacy | 3320 4th Ave Ste F, Conway, SC 29527-6057 | 2012-05-22 |
| 1881909638 | Harps Food Stores, Inc | Pharmacy | 1120 E German Ln, Conway, AR 72032 | 2010-08-17 |
| 1669619094 | Saint-mark Enterprises 1906 LLC | Pharmacy | 2125 College Ave Ste 1, Conway, AR 72034-6387 | 2009-01-07 |
| 1851494629 | South Carolina Cvs Pharmacy LLC | Pharmacy | 707 Church St, Conway, SC 29526-4824 | 2006-09-07 |
| 1649373135 | South Carolina Cvs Pharmacy LLC | Pharmacy | 2296 Hwy 501 East, Conway, SC 29526 | 2006-09-07 |
| 1316969199 | Arkansas Cvs Pharmacy LLC | Pharmacy | 501 Elsinger Blvd, Conway, AR 72032-4717 | 2006-07-24 |
| Find all providers in CONWAY | ||||
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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.