TRANSFORM KM LLC (NPI# 1083645139) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083645139 |
| Entity Type | Organization |
| Organization Name | TRANSFORM KM LLC |
| Other Organization Name | KMART PHARMACY #3750 |
| Practice Address |
830 W Fulton St Waupaca WI 54981-1406 |
| Mailing Address |
3333 Beverly Rd # Bc260a Hoffman Estates IL 60179-0001 |
| Practice Telephone | 7152584285 |
| Practice Fax Number | 8473962686 |
| Mailing Telephone | 8472864089 |
| Mailing Fax Number | 8477471553 |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2019-05-08 |
| Authorized Official Name | JENNIFER SPEARES LEHMAN (HEAD OF PHARMACY) |
| Authorized Official Telephone | 8472865116 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
7016-42 | WI | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2114954 | 01 | |
| WI | 33166000 | 05 |
| Other Name | Type Code |
|---|---|
| KMART PHARMACY #3750 | Doing Business As Name - Organization |
| KMART PHARMACY3750 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295041341 | Transform Km LLC | Pharmacy | 3333 Beverly Rd # Bc260a, Hoffman Estates, IL 60179-0001 | 2010-08-27 |
| 1396947248 | Transform Km LLC | Durable Medical Equipment & Medical Supplies | 250 W 34th St, New York, NY 10119-2152 | 2007-06-04 |
| 1700817772 | Transform Km LLC | Durable Medical Equipment & Medical Supplies | 18 Mark Plz, Kingston, PA 18704-3104 | 2006-07-06 |
| 1295766285 | Transform Km LLC | Durable Medical Equipment & Medical Supplies | 1 K Mart Plz, Greenville, SC 29605-4442 | 2006-07-06 |
| 1134150287 | Transform Km LLC | Durable Medical Equipment & Medical Supplies | 1815 21st St, Lewiston, ID 83501-4103 | 2006-07-06 |
| 1659302636 | Transform Km LLC | Durable Medical Equipment & Medical Supplies | 328 Ennis Ln, Towanda, PA 18848-9212 | 2006-07-06 |
| 1225069362 | Transform Km LLC | Durable Medical Equipment & Medical Supplies | 4100 52nd St, Kenosha, WI 53144-3900 | 2006-07-06 |
| 1649201781 | Transform Km LLC | Durable Medical Equipment & Medical Supplies | 770 Broadway, New York, NY 10003-9522 | 2006-07-06 |
| 1053342030 | Transform Km LLC | Pharmacy | Pr 149 Y 584, Plaza Juana Diaz, Juana Diaz, PR 00795 | 2006-07-06 |
| 1699706689 | Transform Km LLC | Durable Medical Equipment & Medical Supplies | Pr 2 Km 29.7, Centro Gran Caribe 16 II, Vega Alta, PR 00692 | 2006-07-06 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | TRANSFORM KM LLC | 3333 Beverly Rd, Hoffman Estates, IL 60179 |
| Washington State Corporations | TRANSFORM KM LLC | 3333 Beverly Road, Hoffman Estates, IL 60179 |
| New York State Corporations | TRANSFORM KM LLC | 28 Liberty Street, New York, New York 10005 |
| Iowa Business Entities | TRANSFORM KM LLC | 1170 Kane Concourse, Suite 200, Bay Harbor Islands, FL 33154 |
| Virginia Business Entities | Transform KM LLC | 3333 Beverly Rd, Hoffman Estates, Illinois 60179-0001 |
| Connecticut Business Registrations | TRANSFORM KM LLC | 3333 Beverly Road, Hoffman Estates, IL 60179 |
| Colorado Business Entities | Transform KM LLC | 5407 Trillium Boulevard, Suite B120, Hoffman Estates, IL 60192 |
| Street Address |
830 W FULTON ST |
| City | WAUPACA |
| State | WI |
| Zip Code | 54981-1406 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477907954 | Kmart Pharmacy | Pharmacy | 830 W Fulton St, Waupaca, WI 54981-1406 | 2016-04-20 |
| 1235451188 | David Kempfert | Pharmacist | 830 W Fulton St, Waupaca, WI 54981-1406 | 2010-02-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366096141 | Renee Elizabeth Winn | Speech-Language Pathologist | 800 Riverside Drive Dr. 902 Building, Speech Therapy, Waupaca, WI 54981 | 2019-07-30 |
| 1891263216 | Stephanie Rice | Dental Hygienist | N4008 Morgan Dr, Waupaca, WI 54981 | 2018-11-03 |
| 1972092989 | Renew Physical Therapy and Wellness, LLC | Physical Therapist | N2919 County Road Qq, Waupaca, WI 54981 | 2018-05-04 |
| 1366942195 | Lanna Boyle | Physical Medicine & Rehabilitation | E1132 Hillcrest Dr, Waupaca, WI 54981 | 2018-02-19 |
| 1710333893 | Thedacare Medical Center - Waupaca, Inc. | General Acute Care Hospital | N2610 Wi 22, Waupaca, WI 54981 | 2016-05-09 |
| 1750743365 | Kimberly Marie Kraeger | Counselor | Waupaca County Dhhs, 811 Harding St, Waupaca, WI 54981 | 2016-03-23 |
| 1619211596 | Kari Anna Esbensen | Counselor | N2919 Cty Qq, Waupaca, WI 54981 | 2012-11-16 |
| 1396027629 | Roots Wholistic Health | Chiropractor | 717 Churchill St., Waupaca, WI 54981 | 2011-09-13 |
| 1629387006 | Barton Jerome Blum | General Practice | E1803 Melody Lane, Waupaca, WI 54981 | 2010-10-01 |
| 1710219357 | Anne Marie Collins-reed | Social Worker | 315 River Road, New London, WI 54981 | 2010-02-08 |
| Find all providers in zip 54981 | ||||
| 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 |
|---|---|---|---|---|
| 1043269020 | Waupaca Woods Pharmacy, Inc. | Pharmacy | 101 N Western Ave, Waupaca, WI 54981-2201 | 2006-05-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
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| 1902417207 | Ipack Pharmacy LLC | Pharmacy | 17000 W North Ave Ste 108w, Brookfield, WI 53005-4423 | 2020-08-11 |
| 1851939037 | Ascension Wisconsin Pharmacy, Inc | Pharmacy | 10180 Washington Ave Ste 102, Mount Pleasant, WI 53177-1604 | 2019-12-18 |
| 1558906354 | Life Change Rx 4 LLC | Pharmacy | 6300 N 76th St Ste 246, Milwaukee, WI 53218-1208 | 2019-11-15 |
| 1285278978 | Life Change Rx 3 LLC | Pharmacy | 7115 W Capitol Dr, Milwaukee, WI 53216-2051 | 2019-11-05 |
| 1295377703 | Hayat Pharmacy 21 LLC. | Pharmacy | 2333 Northwestern Ave Ste 120, Racine, WI 53404-2520 | 2019-10-16 |
| 1487296737 | Xperience Pharmacy LLC | Pharmacy | 5715 W Appleton Ave, Milwaukee, WI 53210-2250 | 2019-10-08 |
| 1962053421 | Hayat Pharmacy 19 LLC | Pharmacy | 805 W. Layton Ave. Suite A, Milwaukee, WI 53221 | 2019-09-26 |
| 1275182925 | Walgreen Co | Pharmacy | 2265 N Mayfair Rd, Wauwatosa, WI 53226-2207 | 2019-09-05 |
| 1982257200 | Hayat Pharmacy 16 LLC | Pharmacy | 603 N 36th St, Milwaukee, WI 53208-3826 | 2019-07-17 |
| 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.