KMART OF MICHIGAN INC (NPI# 1992736987) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992736987 |
| Entity Type | Organization |
| Organization Name | KMART OF MICHIGAN INC |
| Other Organization Name | KMART PHARMACY3575 |
| Practice Address |
29101 John R Rd Madison Heights MI 48071-5417 |
| Mailing Address |
3333 Beverly Rd Ac 367 B Hoffman Estates IL 60179-0001 |
| Practice Telephone | 2485468076 |
| Practice Fax Number | 2485456837 |
| Mailing Telephone | 8472864089 |
| Mailing Fax Number | 8472861603 |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2014-10-30 |
| Authorized Official Name | DAIN RUSK (VP/GM PHARMACY) |
| Authorized Official Telephone | 8472863348 |
| 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 |
5301004916 | MI | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 2538621 | 05 | |
| PK | 2043000 | 01 |
| Other Name | Type Code |
|---|---|
| KMART PHARMACY3575 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114353919 | Kmart of Michigan Inc | Pharmacy | 2425 S I 75 Business Loop, Grayling, MI 49738-2042 | 2013-09-25 |
| 1609984095 | Kmart of Michigan Inc | Pharmacy | 1151 S Otsego Ave # A, Gaylord, MI 49735-1789 | 2006-08-27 |
| 1760413751 | Kmart of Michigan Inc | Pharmacy | 2500 E M21, Corunna, MI 48817 | 2006-07-06 |
| 1700817780 | Kmart of Michigan Inc | Pharmacy | 19800 West Rd, Woodhaven, MI 48183-3319 | 2006-07-06 |
| 1609807692 | Kmart of Michigan Inc | Pharmacy | 6730 River Rd, Marine City, MI 48039-2284 | 2006-07-06 |
| 1538190517 | Kmart of Michigan Inc | Pharmacy | 100 E Maple Rd, Troy, MI 48083-2714 | 2006-07-06 |
| 1457382434 | Kmart of Michigan Inc | Pharmacy | 215 N Maple Rd, Ann Arbor, MI 48103-2823 | 2006-07-06 |
| 1538190525 | Kmart of Michigan Inc | Pharmacy | 710 Chicago Dr, Holland, MI 49423-3074 | 2006-07-06 |
| 1750312740 | Kmart of Michigan Inc | Pharmacy | 17580 Frazho Rd, Roseville, MI 48066-3829 | 2006-07-06 |
| 1336170323 | Kmart of Michigan Inc | Pharmacy | 2948 S State Rd, Ionia, MI 48846-9475 | 2006-07-06 |
| Street Address |
29101 JOHN R RD |
| City | MADISON HEIGHTS |
| State | MI |
| Zip Code | 48071-5417 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578559712 | Nuha S. Rukieh | Pharmacist | 29101 John R Rd, Madison Heights, MI 48071-5403 | 2005-09-22 |
| 1780282525 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 29101 John R Rd, Madison Heights, MI 48071-5403 | 2020-10-14 |
| 1760817589 | Elisabeth Golus | Pharmacist | 29101 John R Rd, Madison Heights, MI 48071-5417 | 2013-09-11 |
| 1821308040 | Roxanna Kalba | Pharmacist | 29101 John R Rd, Madison Heights, MI 48071-5417 | 2010-10-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952918831 | United Medical Laboratory LLC | Clinical Medical Laboratory | 30675 Stephenson Hwy, Suite B, Madison Heights, MI 48071 | 2020-09-25 |
| 1033776372 | Terry Ky-sieu Tran | Student in an Organized Health Care Education/Training Program | 27351 Dequindre Rd., Madison Height, MI 48071 | 2019-05-22 |
| 1942865894 | Jordan Lee Stav | Student in an Organized Health Care Education/Training Program | Sjmo Emergency Medicine Residency Program, 27351 Dequindre Rd, Madison Heights, MI 48071 | 2019-05-07 |
| 1538624960 | Holistic Therapy Institute Physical Therapy, Inc. | Physical Therapist | 30201 Dequidre Rd Suite1, Madison Hts, MI 48071 | 2019-02-11 |
| 1720558216 | Kevin Luce | Physical Therapy Assistant | 1433 E 12 Mile Road, Madison Heights, MI 48071 | 2018-11-28 |
| 1861974297 | Olubunmi Oluremi Aluko | Physical Therapist | 1410 E.14 Mile Road, Madison Heights, MI 48071 | 2018-09-01 |
| 1558859579 | Leslie G Lafer, Dopllc | Obstetrics & Gynecology | 1437 E 12 Mile Road, Building D, Madison Heights, MI 48071 | 2018-04-25 |
| 1588161020 | Daniel Eugene Geer | Physical Therapist | 1410 E 14 Mile Road, Madison Heights, MI 48071 | 2018-04-11 |
| 1881100931 | Medshop Pharmacy LLC | Pharmacy | 30549 Stephenson Hwy Ste B, Madison Heights, MI 48071 | 2017-12-26 |
| 1730602004 | Ali Bazzy | Nurse Practitioner | 27483 Dequindre Suite 304, Madison Hgts, MI 48071 | 2017-07-19 |
| Find all providers in zip 48071 | ||||
| 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 |
|---|---|---|---|---|
| 1508408246 | Aspop, LLC | Pharmacy | 27351 Dequindre Rd Ste 199, Madison Heights, MI 48071-3487 | 2019-10-15 |
| 1235609249 | Great Health Pharmacy Inc | Pharmacy | 28147 John R Rd, Madison Heights, MI 48071-2810 | 2018-12-03 |
| 1881100931 | Medshop Pharmacy LLC | Pharmacy | 30549 Stephenson Hwy Ste B, Madison Heights, MI 48071 | 2017-12-26 |
| 1588173777 | Neha Pharmacy Inc | Pharmacy | 30551 Stephenson Hwy Ste 1, Madison Heights, MI 48071-1648 | 2017-09-20 |
| 1124488168 | Ayama Corp | Pharmacy | 26795 John R Road Suite B, Madison Heights, MI 48071 | 2016-03-03 |
| 1205260841 | John R Express Pharmacy PC | Pharmacy | 26100 John R Rd, Madison Heights, MI 48071-3648 | 2013-08-31 |
| 1770642837 | Virginia Cvs Pharmacy L L C | Pharmacy | 4861 Amherst Hwy, Madison Heights, VA 24572-2497 | 2006-12-06 |
| 1538261813 | Woodward Detroit Cvs, L.L.C. | Pharmacy | 31030 John R Rd, Madison Heights, MI 48071 | 2006-09-05 |
| 1457463382 | Woodward Detroit Cvs, L.L.C. | Pharmacy | 27050 John R Rd, Madison Heights, MI 48071-3326 | 2006-08-31 |
| 1932219557 | Costco Wholesale Corporation | Pharmacy | 30550 Stephenson Hwy, Madison Heights, MI 48071 | 2006-08-30 |
| Find all providers in MADISON HEIGHTS | ||||
| City | MADISON HEIGHTS |
| Zip Code | 48071 |
Please comment or provide details below to improve the information on KMART OF MICHIGAN INC.
| 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.