K MART CORP (NPI# 1093746125) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093746125 |
| Entity Type | Organization |
| Organization Name | K MART CORP |
| Other Organization Name | KMART PHARMACY4887 |
| Practice Address |
1363 Nw Saint Lucie West Blvd Port St Lucie FL 34986-2196 |
| Mailing Address |
3333 Beverly Rd Ac 367 B Hoffman Estates IL 60179-0001 |
| Practice Telephone | 7728716995 |
| Practice Fax Number | 7723445698 |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2008-10-10 |
| Authorized Official Name | ROBBERT AYSHFORD (DIRECTOR OF PHARMACY ADMINISTRATION) |
| Authorized Official Telephone | 8472868242 |
| 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 |
PH0012697 | FL | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 102699200 | 05 | |
| NCPDP PROVIDER IDENTIFICATION NUMBER | 1071860 | 01 |
| Other Name | Type Code |
|---|---|
| KMART PHARMACY4887 | 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 |
1363 NW SAINT LUCIE WEST BLVD |
| City | PORT ST LUCIE |
| State | FL |
| Zip Code | 34986-2196 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619027190 | Cole Vision Corporation | Eyewear Supplier (Equipment, not the service) | 1363 Nw Saint Lucie West Blvd, Port St Lucie, FL 34986-2196 | 2007-01-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962992933 | Lindsay B Rojas | Occupational Therapist | 827 Sw Grand Reserves Blvd, Port St Lucie, FL 34986 | 2018-05-15 |
| 1639685266 | Natoya A Queenbourrows | Family Medicine | 2145 Nw Padova St, Port St Lucie, FL 34986 | 2017-12-19 |
| 1740634930 | The Toledo Clinic, LLC | Clinic/Center | 5481 Nw East Torino Parkway, Port St. Lucie, FL 34986 | 2016-04-14 |
| 1326407230 | Merline Smellie | Social Worker | 525 Nw Lake Whitney Place, Ste 102 & 103, Port St Lucie, FL 34986 | 2016-02-19 |
| 1124486949 | Therapy Connection of The Treasure Coast | Speech-Language Pathologist | 549 Nw Lake Whitney Pl Ste 104, Port St Lucie, FL 34986 | 2016-02-08 |
| 1689050015 | Yudelquis Comas Sanchez | Internal Medicine | Lawnwood Regional Medical Center, 1700 S 23rd St, Fort Pierce, FL 34986 | 2015-08-07 |
| 1689056889 | Joshua Chupp | Dentist | 1384 Sw St. Lucie West Blvd, Port St. Lucie, FL 34986 | 2015-06-24 |
| 1366821720 | Kids Therapy Solutions | Occupational Therapist | 161 Sw Palm Dr # 201, Port St Lucie, FL 34986 | 2015-05-19 |
| 1134514086 | Comfortable Care Dental Health Professionals, Pa | Dentist | 1384 Sw St. Lucie, Port St. Lucie, FL 34986 | 2015-03-30 |
| 1750787586 | Timothy Michael Kennedy | Chiropractor | 1680 Sw Saint Lucie West Blvd Ste 204, Port St Lucie, FL 34986 | 2014-11-05 |
| Find all providers in zip 34986 | ||||
| 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 |
|---|---|---|---|---|
| 1548650088 | Clover Pharmacy Inc | Pharmacy | 259-357 Se Port St Lucie Blvd, Port St Lucie, FL 34952 | 2015-02-04 |
| 1427489939 | Remed Pharmacy | Pharmacy | 10163 S Us Highway 1, Port St Lucie, FL 34952-5610 | 2013-12-09 |
| 1629371679 | Pappy's Drugs, Inc | Pharmacy | 889 E Prima Vista Blvd, Port St Lucie, FL 34952-2342 | 2010-12-14 |
| 1790863066 | Value Health Consultants | Pharmacy | 1707 Nw Saint Lucie West Blvd Ste 166, Port St Lucie, FL 34986-2520 | 2006-11-02 |
| 1831293810 | Holiday Cvs LLC | Pharmacy | 9197 S Us Highway 1, Port St Lucie, FL 34952-3405 | 2006-09-12 |
| 1225132103 | Holiday Cvs LLC | Pharmacy | 2873 Sw Port St Lucie Blvd, Port St Lucie, FL 34953-2884 | 2006-09-12 |
| 1245247238 | Walgreen Co | Pharmacy | 9000 S Us Highway 1, Port St Lucie, FL 34952-3408 | 2006-08-02 |
| 1407365513 | Martin Memorial Physicians Corp | Pharmacy | 10080 Sw Innovation Way Ste 102, Port St Lucie, FL 34987-2129 | 2017-09-21 |
| 1427487396 | Walmart Pharmacy | Pharmacy | 1675 Nw Saint Lucie West Blvd, Port St Lucie, FL 34986-2106 | 2013-11-01 |
| 1215219241 | Walgreens | Pharmacy | 1661 Nw Saint Lucie West Blvd, Port St Lucie, FL 34986-2106 | 2011-09-15 |
| Find all providers in PORT ST LUCIE | ||||
| City | PORT ST LUCIE |
| Zip Code | 34986 |
Please comment or provide details below to improve the information on K MART CORP.
| 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.