K MART CORP (NPI# 1083645113) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083645113 |
| Entity Type | Organization |
| Organization Name | K MART CORP |
| Other Organization Name | KMART PHARMACY3072 |
| Practice Address |
3626 Brooks St Missoula MT 59801-7360 |
| Mailing Address |
3333 Beverly Rd Ac 367 B Hoffman Estates IL 60179-0001 |
| Practice Telephone | 4062510497 |
| Practice Fax Number | 4062510240 |
| Mailing Telephone | 8472864089 |
| Mailing Fax Number | 8472861603 |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2012-02-10 |
| Authorized Official Name | GHASSAN HOURANI (VP/GMM PHARMACY ADMIN) |
| Authorized Official Telephone | 8472863382 |
| 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 |
1020 | MT | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NCPDP PROVIDER IDENTIFICATION NUMBER | 2706325 | 01 | |
| MT | 2706325 | 05 |
| Other Name | Type Code |
|---|---|
| KMART PHARMACY3072 | 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 |
3626 BROOKS ST |
| City | MISSOULA |
| State | MT |
| Zip Code | 59801-7360 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487812657 | Maria T Angelici | Pharmacist | 3626 Brooks St, Missoula, MT 59801-7360 | 2008-05-23 |
| 1427340843 | Jon Berman | Pharmacist | 3626 Brooks St, Missoula, MT 59801-7360 | 2011-05-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629681010 | Time To Thrive Pllc | Social Worker | 1836 South Ave. West, Missoula, MT 59801 | 2020-08-26 |
| 1740815653 | Yuzo Fujiki | Specialist/Technologist | 210 N California St 104, Missoula, MT 59801 | 2020-03-11 |
| 1407346596 | Stepping Stones Counseling, Pllc | Counselor | 202 Brooks St Ste 300, Missoula, MT 59801 | 2018-05-14 |
| 1437668530 | Rejuve Care Clinic, Inc | Plastic Surgery | 715 Kensingten, Ste 1, Missoula, Missoula, MT 59801 | 2017-09-21 |
| 1619499555 | Beatrice Elise Powers | Specialist/Technologist | 410 B Stephens Ave, Missoula, MT 59801 | 2017-07-12 |
| 1770012197 | Hannah Lepiane | Massage Therapist | 1313 S. 4th W., Missoula, MT 59801 | 2017-06-08 |
| 1811420227 | Celeste Willis | Social Worker | 1055 W. Sussex, Missoula, MT 59801 | 2017-04-04 |
| 1073050498 | Rina Kasuga | Specialist/Technologist | 913 Rimini Ct, Missoula, MT 59801 | 2017-01-24 |
| 1043756919 | Heather Bartz | Specialist/Technologist | 831 Hastings Ave, Missoula, MT 59801 | 2017-01-16 |
| 1255874517 | Sarabeth Haddad | Social Worker | 1055 W Sussex Ave, Missoula, MT 59801 | 2016-11-18 |
| Find all providers in zip 59801 | ||||
| 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 |
|---|---|---|---|---|
| 1659425718 | Savmor Drug I, Inc. | Pharmacy | 1610 S 3rd St W, Ste 100, Missoula, MT 59801-9012 | 2007-01-23 |
| 1649380262 | Costco Wholesale Corporation | Pharmacy | 3220 N Reserve St, Missoula, MT 59808 | 2006-08-30 |
| 1780135186 | Rosauers Food and Drug #27 | Pharmacy | 2350 S Reserve St, Missoula, MT 59801-6447 | 2016-10-20 |
| 1588062509 | Rchp Billings - Missoula LLC | Pharmacy | 2835 Fort Missoula Rd, Missoula, MT 59804-7423 | 2014-12-08 |
| 1184978090 | Credena Health LLC | Pharmacy | 500 W Broadway St, Missoula, MT 59802-4008 | 2012-10-30 |
| 1700998705 | Missoula Pharmacy Inc | Pharmacy | 1211 S Reserve St, Ste 102, Missoula, MT 59801-3102 | 2006-08-31 |
| 1972613388 | Credena Health LLC | Pharmacy | 500 W Broadway St, Missoula, MT 59802-4008 | 2006-08-30 |
| 1720011190 | Heffernan Drug Inc | Pharmacy | 918 Sw Higgins Ave, Missoula, MT 59803-3606 | 2006-07-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023630662 | Pharm406 Inc | Pharmacy | 1410 38th St W Ste A, Billings, MT 59102-7552 | 2020-05-16 |
| 1710521679 | Billmont Rx, LLC | Pharmacy | 1603 Grand Ave Ste 250, Billings, MT 59102-3000 | 2019-11-04 |
| 1235636689 | Daniel Patrick Doran | Pharmacy | 590 Stockett Rd, Sand Coulee, MT 59472-9745 | 2018-04-11 |
| 1477069193 | 406 Rx Pllc | Pharmacy | 117 N Main St Ste A, Three Forks, MT 59752-9013 | 2017-12-18 |
| 1508385477 | Jkw & Jira Inc. | Pharmacy | 1245 N 29th St Ste 100, Billings, MT 59101 | 2017-09-12 |
| 1326564857 | Billings Clinic Specialty Supplies and Services, LLC | Pharmacy | 1015 Broadwater Ave Ste 101, Billings, MT 59102 | 2017-08-16 |
| 1679977433 | Superior Specialty Pharmacy of Montana, LLC | Pharmacy | 20 Four Mile Dr Ste 4, Kalispell, MT 59901-2644 | 2014-10-22 |
| 1134439797 | Kc Western Drug | Pharmacy | 105 E 1st, Clyde Park, MT 59018-0000 | 2010-10-18 |
| 1669795647 | Broadus Foods, Inc | Pharmacy | 120 S Park Avenue, Broadus, MT 59317-0549 | 2010-03-05 |
| 1316135940 | Rosauers Supermarkets Inc | Pharmacy | 3255 Technology Blvd W, Bozeman, MT 59718-6854 | 2007-10-09 |
| 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.