K MART CORP (NPI# 1023049145) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023049145 |
| Entity Type | Organization |
| Organization Name | K MART CORP |
| Other Organization Name | KMART PHARMACY3324 |
| Practice Address |
3533 Franklin Rd Sw Roanoke VA 24014-2201 |
| Mailing Address |
3333 Beverly Rd Ac 367 B Hoffman Estates IL 60179-0001 |
| Practice Telephone | 5409819321 |
| Practice Fax Number | 5408570367 |
| 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 |
0201001362 | VA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2102976 | 01 | |
| VA | 008526672 | 05 | |
| VA | 8526672 | 05 |
| Other Name | Type Code |
|---|---|
| KMART PHARMACY3324 | 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 |
3533 FRANKLIN RD SW |
| City | ROANOKE |
| State | VA |
| Zip Code | 24014-2201 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538481387 | James Blankenship | Pharmacist | 3533 Franklin Rd Sw, Roanoke, VA 24014-2201 | 2010-02-22 |
| 1952764508 | Gary Tickle | Pharmacist | 3533 Franklin Rd Sw, Roanoke, VA 24014-2201 | 2016-03-31 |
| 1639543630 | Ezra Yohannes | Pharmacist | 3533 Franklin Rd Sw, Roanoke, VA 24014-2201 | 2015-11-14 |
| 1750798153 | Tiffany Dawson | Pharmacist | 3533 Franklin Rd Sw, Roanoke, VA 24014-2201 | 2014-07-17 |
| 1871815126 | John Addison Mathews | Pharmacist | 3533 Franklin Rd Sw, Roanoke, VA 24014-2201 | 2010-02-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417558602 | Irene Pace Seidman | Pharmacist | 3350 Clearbrook Village Ln, Roanoke, VA 24014 | 2020-11-04 |
| 1720617970 | Mounica Reddy Thootkur | Student in an Organized Health Care Education/Training Program | 2017 South Jefferson Street, 2nd Floor, Roanoke, VA 24014 | 2020-04-08 |
| 1326675422 | Bharath Muppala | Student in an Organized Health Care Education/Training Program | Carilion Roanoke Memorial Hospital, 1906 Belleview Ave, Roanoke, VA 24014 | 2020-03-26 |
| 1235629239 | Sanjeeb Sudarshan Bhandari | Student in an Organized Health Care Education/Training Program | 1906 Bellview Ave Se, Roanoke, VA 24014 | 2018-05-15 |
| 1104325778 | Vera J. Short | Registered Nurse | 3167 Huffman Ln, Roanoke, VA 24014 | 2018-02-08 |
| 1770001380 | Michael Alan Phillips I | Social Worker | 2017 Jefferson Street, Roanoke, VA 24014 | 2017-09-03 |
| 1306362884 | Sara Alicia Guasch | Student in an Organized Health Care Education/Training Program | Carilion Roanoke Memorial Hospital, 1906 Belleview Ave, Roanoke, VA 24014 | 2017-08-16 |
| 1790212256 | Pouya Mafi | Student in an Organized Health Care Education/Training Program | 1906 Belleview Ave, Carilion Roanoke Memorial Hospital, Roanoke, VA 24014 | 2017-05-16 |
| 1790222867 | Mara Cate | Physician Assistant | 523 Arbuttus Ave, Roanoke, VA 24014 | 2017-01-26 |
| 1508314634 | Dknl Enterprises, Inc. | Non-emergency Medical Transport (VAN) | 3629 Franklin Rd Sw Suite 205b, Roanoke, VA 24014 | 2016-09-19 |
| Find all providers in zip 24014 | ||||
| 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 |
|---|---|---|---|---|
| 1770910655 | Shawsville Pharmacy Inc | Pharmacy | 300 1st St Sw, Roanoke, VA 24011-1901 | 2013-10-08 |
| 1144520446 | Eagle Drugs LLC | Pharmacy | 3705 Hwy 431, Roanoke, AL 36274 | 2010-11-02 |
| 1265535991 | Virginia Cvs Pharmacy LLC | Pharmacy | 1916 Orange Ave Nw, Roanoke, VA 24017-4040 | 2006-09-07 |
| 1336242064 | Virginia Cvs Pharmacy LLC | Pharmacy | 4400 Brambleton Ave, Roanoke, VA 24018-3427 | 2006-09-07 |
| 1073616710 | Virginia Cvs Pharmacy LLC | Pharmacy | 4126 Plantation Rd Ne, Roanoke, VA 24012-3136 | 2006-09-07 |
| 1184731192 | Emerging Home Care, Inc. | Pharmacy | 3868 Highway 431, Roanoke, AL 36274-2640 | 2006-08-24 |
| 1376659458 | West Pharmacy, LLC | Pharmacy | 2012 Electric Rd, Roanoke, VA 24018-1938 | 2006-08-22 |
| 1740202423 | Virginia Cvs Pharmacy LLC | Pharmacy | 4737 Valley View Blvd Nw, Roanoke, VA 24012-2000 | 2006-07-24 |
| 1558308015 | Rls Supermarkets LLC | Pharmacy | 1108 N Highway 377, Roanoke, TX 76262-9121 | 2006-06-01 |
| 1255314258 | Jebs Inc | Pharmacy | 4375 Brambleton Ave, Roanoke, VA 24018-3404 | 2005-11-22 |
| Find all providers in ROANOKE | ||||
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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.