K MART CORP (NPI# 1992736003) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992736003 |
| Entity Type | Organization |
| Organization Name | K MART CORP |
| Other Organization Name | KMART PHARMACY3923 |
| Practice Address |
300 W Mariposa Rd Nogales AZ 85621-1043 |
| Mailing Address |
3333 Beverly Rd Ac 367 B Hoffman Estates IL 60179-0001 |
| Practice Telephone | 5207614117 |
| Practice Fax Number | 5207611911 |
| 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 |
Y002391 | AZ | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 308074 | 05 | |
| PK | 1989407 | 01 | |
| AZ | 124694 | 05 |
| Other Name | Type Code |
|---|---|
| KMART PHARMACY3923 | 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 |
300 W MARIPOSA RD |
| City | NOGALES |
| State | AZ |
| Zip Code | 85621-1043 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245552868 | Kenneth Sterling Shipley | Pharmacist | 300 W Mariposa Rd, Nogales, AZ 85621-1043 | 2010-02-23 |
| 1679974067 | Juan Pablo Valenzuela | Pharmacist | 300 W Mariposa Rd, Nogales, AZ 85621-1043 | 2014-09-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548771033 | Intermountain Health Center, Inc. | Community/Behavioral Health | 272 West Viewpoint Drive, Nogales, AZ 85621 | 2017-10-24 |
| 1336696657 | Intermountain Centers for Human Development Inc. | Community/Behavioral Health | 276 West View Point Drive, Nogales, AZ 85621 | 2016-09-02 |
| 1831584291 | Helping Ourselves Pursue Enrichment, Inc. | Community/Behavioral Health | 1857 N Mastick Way, Nogales, AZ 85621 | 2015-04-02 |
| 1043504376 | Community Intervention Associates | Community/Behavioral Health | 32 Blvd Del Rey David, Nogales, AZ 85621 | 2011-06-03 |
| 1568782175 | Arizona's Children Association | Clinic/Center | 1740 N. Mastick Way, Suite D, Nogales, AZ 85621 | 2010-06-04 |
| 1811032493 | Susan M. Jaworski | Local Education Agency (LEA) | 315 Plum Street, Nogales, AZ 85621 | 2007-02-21 |
| 1194885905 | Alex Gracia | Pharmacy Technician | 839 W. Calle Chico, Nogales, AZ 85621 | 2006-12-11 |
| 1982716130 | Yvette Denise Braun | Chiropractor | 1821 N Mastick Way #1, Nogales, AZ 85621 | 2006-08-31 |
| 1043254154 | John Diaz | Emergency Medicine | 1171 W Target Range Road, Carondelet Holy Cross Hospital, Nogales, AZ 85621 | 2006-06-16 |
| 1467495085 | Bart L Mc Rae | Emergency Medicine | Carondelet Holy Cross Hospital, 1171 W. Target Range Road, Nogales, AZ 85621 | 2006-06-13 |
| Find all providers in zip 85621 | ||||
| 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 |
|---|---|---|---|---|
| 1639198724 | Bashas' Inc. | Pharmacy | 450 N Grand Court Plz, Nogales, AZ 85621-2748 | 2006-07-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255946562 | Grand Canyon Acquisition Co LLC | Pharmacy | 100 E Camelback Rd Ste 112, Phoenix, AZ 85012-1061 | 2020-09-14 |
| 1316564628 | Costco Wholesale Corporation | Pharmacy | 16385 W Waddell Rd, Surprise, AZ 85388-9623 | 2020-07-02 |
| 1669098257 | Nowrx Inc | Pharmacy | 2452 W Birchwood Ave Ste 106, Mesa, AZ 85202-1067 | 2020-06-19 |
| 1356961726 | Truechoice Pharmacy, LLC | Pharmacy | 2410 Highway 95, Bullhead City, AZ 86442-7305 | 2020-04-25 |
| 1861021495 | Walgreen Co | Pharmacy | 1870 W Rio Salado Pkwy Ste 100rx, Tempe, AZ 85281-2695 | 2020-04-06 |
| 1134757503 | Adhererx Incorporated | Pharmacy | 1343 N Colorado St Ste 109, Gilbert, AZ 85233-1618 | 2020-03-31 |
| 1003458332 | Bee's Marketplace Corporation | Pharmacy | 80 North Central Street Unit 6 #3323, Colorado City, AZ 86021 | 2019-10-08 |
| 1508417189 | Call's Community Pharmacy LLC | Pharmacy | 985 S Main St, Snowflake, AZ 85937-5501 | 2019-09-24 |
| 1609429240 | Medavail Pharmacy Inc. | Pharmacy | 5555 E 5th St # 101, Tucson, AZ 85711-2415 | 2019-07-23 |
| 1417513904 | N & R Bryce Enterprises LLC | Pharmacy | 2841 Highway 260 Suite 2, Overgaard, AZ 85933 | 2019-05-10 |
| 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.