K-MART (NPI# 1952755472) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952755472 |
| Entity Type | Organization |
| Organization Name | K-MART |
| Practice Address |
2304 Missouri Blvd Jefferson City MO 65109-4729 |
| Practice Telephone | 5736344400 |
| Practice Fax Number | 5736360672 |
| Enumeration Date | 2016-04-21 |
| Last Update Date | 2016-04-21 |
| Authorized Official Name | MR. ANCELL J REID III (STAFF PHARMACIST) |
| Authorized Official Telephone | 5736344400 |
| Authorized Official Credential | RPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
028660 | MO | Suppliers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649324468 | K-mart | Pharmacist | 4570 Ladson Rd, Summerville, SC 29485-8531 | 2007-01-22 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Connecticut Business Registrations | K-MART APPAREL OF CONNECTICUT CORP. | 7373 West Side Ave, North Bergen, NJ 07047 |
| Oregon Corporations, Companies and Business Names | K-MARTIAL ARTS | 7777 Se Mcbride St, Portland, OR 97222 |
| Street Address |
2304 MISSOURI BLVD |
| City | JEFFERSON CITY |
| State | MO |
| Zip Code | 65109-4729 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699007930 | Jerry A Schupp | Pharmacist | 2304 Missouri Blvd, Jefferson City, MO 65109-4729 | 2010-02-11 |
| 1386008290 | Ancell Reid IIi | Pharmacist | 2304 Missouri Blvd, Jefferson City, MO 65109-4729 | 2016-04-06 |
| 1831421080 | Kathleen Wilbers | Pharmacist | 2304 Missouri Blvd, Jefferson City, MO 65109-4729 | 2010-02-12 |
| 1639401888 | Luke Boehmer | Pharmacist | 2304 Missouri Blvd, Jefferson City, MO 65109-4729 | 2010-02-12 |
| 1689906828 | Robert Craig Pryor | Pharmacist | 2304 Missouri Blvd, Jefferson City, MO 65109-4729 | 2010-02-12 |
| 1326079443 | Kmart Operations LLC | Pharmacy | 2304 Missouri Blvd, Jefferson City, MO 65109-4729 | 2006-07-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518449321 | Kara D Roderick | Physical Therapist | 1115 Fairgrounds Road, Jefferson City, MO 65109 | 2018-08-29 |
| 1851871214 | Integrative Medicine, LLC | Internal Medicine | 999 Diamond Rdg Ste 201, Jefferson City, MO 65109 | 2018-08-15 |
| 1972020394 | Rehab Care Group East, LLC | Clinic/Center | Primrose Retirement Community Jefferson City, 1214 Freedom Boulevard, Jefferson City, MO 65109 | 2017-08-25 |
| 1124558986 | Nicholas Rehagen | Specialist/Technologist | 304 Timber Creek Rd, Jefferson City, MO 65109 | 2017-06-14 |
| 1982004214 | Kara Elizabeth Wilbers | Occupational Therapist | 1105 Fairgrounds Rd, Jefferson City, MO 65109 | 2014-08-22 |
| 1942510334 | Loftin Eyecare, LLC | Optometrist | 724 West Stadium Boulevard, # 029 Walmart Vision Center, Jefferson City, MO 65109 | 2010-10-19 |
| 1306077250 | Paula Hancock Johnson | Social Worker | 1303 Edgewood Dr Ste 5, Jefferson City, MO 65109 | 2009-07-27 |
| 1679701296 | Capital Region Medical Center | Family Medicine | 3308 W Edgewood, Suite B, Jefferson City, MO 65109 | 2009-06-23 |
| 1972730141 | Nancy S Stork | Counselor | 204 Metro, Suite B, Jefferson City, MO 65109 | 2009-06-16 |
| 1356522916 | Walk Easy LLC | Durable Medical Equipment & Medical Supplies | 4810 Rainbow Dr., Jefferson City, MO 65109 | 2007-11-23 |
| Find all providers in zip 65109 | ||||
| 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 |
|---|---|---|---|---|
| 1104905884 | Murphys Sav-mor Pharmacy Inc | Pharmacy | 1403 Russell Ave, Jefferson City, TN 37760-2530 | 2006-11-03 |
| 1023113248 | Jefferson City Apothecary LLC | Pharmacy | 1739 Elm Ct Ste 108, Jefferson City, MO 65101-4303 | 2006-09-13 |
| 1578666277 | Tennessee Cvs Pharmacy LLC | Pharmacy | 139 E Broadway Blvd, Jefferson City, TN 37760-2536 | 2006-09-07 |
| 1326055344 | Walgreen Co | Pharmacy | 3740 W Truman Blvd, Jefferson City, MO 65109-0537 | 2006-08-02 |
| 1750396784 | Walgreen Co | Pharmacy | 132 E Broadway Blvd, Jefferson City, TN 37760-2535 | 2006-07-29 |
| 1194767384 | Missouri Cvs Pharmacy LLC | Pharmacy | 735 W Stadium Blvd, Jefferson City, MO 65109-4753 | 2006-06-12 |
| 1073979522 | Jeff City Pharmacist Group LLC Dba Md Pharmacy Store 2 | Pharmacy | 657 E Broadway Blvd, Jefferson City, TN 37760 | 2016-01-13 |
| 1922417021 | Walgreens | Pharmacy | 900 Eastland Dr, Jefferson City, MO 65101-3894 | 2014-08-04 |
| 1194084772 | Capital Care Pharmacy | Pharmacy | 1125 Madison St, Jefferson City, MO 65101-5227 | 2012-05-16 |
| 1497942056 | Whaley's Pharmacy Inc | Pharmacy | 630 E High St, Jefferson City, MO 65101-3219 | 2007-09-27 |
| Find all providers in JEFFERSON CITY | ||||
| City | JEFFERSON CITY |
| Zip Code | 65109 |
Please comment or provide details below to improve the information on K-MART.
| 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.