KMART PHARMACY # 4156 (NPI# 1023462355) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023462355 |
| Entity Type | Organization |
| Organization Name | KMART PHARMACY # 4156 |
| Practice Address |
7501 Hickman Rd Urbandale IA 50322-4603 |
| Practice Telephone | 5152702623 |
| Mailing Telephone | 5152702623 |
| Enumeration Date | 2016-04-23 |
| Last Update Date | 2016-04-23 |
| Authorized Official Name | PRESTON J WITT (PHARMACIST MANAGER) |
| Authorized Official Telephone | 5152702623 |
| 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 |
16824 | IA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GROUP NPI KMART PHARMACY 4156 | 1417988478 | 01 |
| Street Address |
7501 HICKMAN RD |
| City | URBANDALE |
| State | IA |
| Zip Code | 50322-4603 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811219215 | Megan Marie Anderson | Pharmacist | 7501 Hickman Rd, Urbandale, IA 50322-4603 | 2010-02-26 |
| 1316390859 | Andrew Riesberg | Pharmacist | 7501 Hickman Rd, Urbandale, IA 50322-4603 | 2016-07-20 |
| 1730543588 | Thomas Suttie I | Pharmacist | 7501 Hickman Rd, Urbandale, IA 50322-4603 | 2016-04-07 |
| 1659736395 | John Lichty | Pharmacist | 7501 Hickman Rd, Urbandale, IA 50322-4603 | 2015-12-23 |
| 1417988478 | K Mart Corp | Pharmacy | 7501 Hickman Rd, Urbandale, IA 50322-4603 | 2006-07-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598278434 | Mary Melissa Buchanan | Hospice Care, Community Based | 6101 Goodman Dr, Urbandale, IA 50322 | 2017-11-14 |
| 1932629110 | Kelsey Coaldrake | Speech-Language Pathologist | 2570 106th St Ste E, Urbandale, IA 50322 | 2017-06-20 |
| 1861940207 | Jessalynn Bradley | Home Health Aide | 8704 Meredith Dr., Apt. 208, Urbandale, IA 50322 | 2016-09-14 |
| 1083086862 | Iowa Dermatology Clinic, Plc | Dermatology | 3729 86th St, Urbandale, IA 50322 | 2015-10-20 |
| 1598134686 | Iowa Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 14201 Hickman Rd., Urbandale, IA 50322 | 2015-09-18 |
| 1114303484 | Monique I Elgersma | Marriage & Family Therapist | 3829 71st St Ste A, Urbandale, IA 50322 | 2015-08-10 |
| 1821437922 | Maggie Lynn Leavens | Physical Therapy Assistant | 4614 84th Street, Urbandale, IA 50322 | 2013-06-21 |
| 1225378581 | Nicholas David Burton Lantz | Physical Therapy Assistant | 4614 Nw 84th Street, Urbandale, IA 50322 | 2013-02-25 |
| 1750645826 | Joseph Horn Thompson | Pharmacist | 9616 Quail Ridge, Urbandale, IA 50322 | 2012-07-03 |
| 1437481827 | Community Support Advocates, LLC | Social Worker | 6000 Aurora Avenue, Suite B, Des Moines, IA 50322 | 2010-02-10 |
| Find all providers in zip 50322 | ||||
| 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 |
|---|---|---|---|---|
| 1548275852 | Walgreen Co | Pharmacy | 7000 Douglas Ave, Urbandale, IA 50322-3224 | 2006-07-29 |
| 1194747832 | Iowa Cvs Pharmacy LLC | Pharmacy | 11148 Plum Dr, Urbandale, IA 50322-6328 | 2006-07-24 |
| 1124534532 | Patrick J. Walter | Pharmacy | 11333 Aurora Ave, Urbandale, IA 50322-7908 | 2017-12-20 |
| 1023551819 | Unitypoint At Home | Pharmacy | 11333 Aurora Ave, Urbandale, IA 50322-7908 | 2016-11-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013546308 | Hy Vee Inc | Pharmacy | 911 S K Ave, Vinton, IA 52349-1073 | 2020-04-07 |
| 1164050944 | Corridor Pharmacy | Pharmacy | 650 W Cherry St Ste 7, North Liberty, IA 52317-9025 | 2020-03-29 |
| 1932740024 | St Luke's Jones Regional Medical Center | Pharmacy | 1795 Highway 64 E Ste 2, Anamosa, IA 52205-2112 | 2019-10-01 |
| 1316407018 | Harlan Pharmacy, LLC | Pharmacy | 1024 5th St, Harlan, IA 51537-1427 | 2019-03-20 |
| 1306304027 | State University of Iowa | Pharmacy | 1360 N Dodge St Ste 1100, Iowa City, IA 52245-6104 | 2019-03-12 |
| 1265999387 | Bancroft Apothecary Lp | Pharmacy | 106 W Ramsey St, Bancroft, IA 50517-8078 | 2019-02-25 |
| 1023588159 | Mark Oleson | Pharmacy | 1100 Broad Street, Adair, IA 50002 | 2018-12-02 |
| 1598235723 | Cjk Pharmacy, LLC | Pharmacy | 3100 E Ave Nw Ste 102, Cedar Rapids, IA 52405-2962 | 2018-11-30 |
| 1144701582 | Madsen Inc | Pharmacy | 307 2nd. St., Gladbrook, IA 50635-5063 | 2018-08-23 |
| 1376024869 | Hy Vee Inc | Pharmacy | 3285 Crosspark Road, Coralville, IA 52241 | 2018-08-23 |
| 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.