K MART CORP (NPI# 1104857226) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104857226 |
| Entity Type | Organization |
| Organization Name | K MART CORP |
| Other Organization Name | KMART PHARMACY4212 |
| Practice Address |
7807 Sudley Rd Manassas VA 20109-2805 |
| Mailing Address |
3333 Beverly Rd Ac 367 B Hoffman Estates IL 60179-0001 |
| Practice Telephone | 7033612416 |
| Practice Fax Number | 7033927661 |
| Mailing Telephone | 8472864089 |
| Mailing Fax Number | 8472861603 |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2012-07-30 |
| 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 |
0201001907 | VA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | 008526796 | 05 | |
| NCPDP PROVIDER IDENTIFICATION NUMBER | 4817358 | 01 | |
| VA | 8526796 | 05 |
| Other Name | Type Code |
|---|---|
| KMART PHARMACY4212 | 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 |
7807 SUDLEY RD |
| City | MANASSAS |
| State | VA |
| Zip Code | 20109-2805 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881916914 | Barbara Lanette Allen | Pharmacist | 7807 Sudley Rd, Manassas, VA 20109-2805 | 2010-02-16 |
| 1538481312 | Cristi N. Buswell | Pharmacist | 7807 Sudley Rd, Manassas, VA 20109-2805 | 2010-02-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275151854 | Laura Zabel | Social Worker | 10220 Launch Circle #103, Manassas, VA 20109 | 2020-07-09 |
| 1659910677 | Leigh Cristi Babin-adkins | Registered Nurse | 10550 Linden Lake Plazza, Manassas, VA 20109 | 2019-12-23 |
| 1326686221 | Sophie Louise Elliot | Speech-Language Pathologist | 10550 Linden Lake Plaza Suite 100, Manassas, VA 20109 | 2019-12-11 |
| 1962978221 | Dominique Marie Cytryn | Behavior Technician | Family Insight, P.C., 7730 Donegan Dr, Manassas, VA 20109 | 2018-10-15 |
| 1255829008 | Lyusyena Teper | Physical Therapist | 11662 Sudley Manor Dr Ste 50-b, Manassas, VA 20109 | 2018-04-27 |
| 1861995060 | Mylisa L Ickes | Counselor | 7982 Donegan Drive, Manassas, VA 20109 | 2018-03-14 |
| 1336641885 | Stephanie Joanne Gamboa | Behavior Technician | 1037 Battleview Pkwy, Manassas, VA 20109 | 2018-03-01 |
| 1154822237 | Katherine Sholl | Behavior Technician | 10370 Battleview Parkway, Manassas, VA 20109 | 2018-02-23 |
| 1386168615 | Northern Virginia Checker Cab LLC | Taxi | 7631 Coppermine Dr, Manassas, VA 20109 | 2017-07-28 |
| 1407383201 | Monique Lowery | Social Worker | 7403 Emerald Dr., Manassas, VA 20109 | 2017-05-11 |
| Find all providers in zip 20109 | ||||
| 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 |
|---|---|---|---|---|
| 1881128544 | Amity Health Inc | Pharmacy | 8724 Sudley Rd, Manassas, VA 20110-4405 | 2017-04-19 |
| 1710380142 | Care 4 U Pharmacy | Pharmacy | 10458 Dumfries Rd, Manassas, VA 20110-7958 | 2014-09-30 |
| 1871921809 | Aka LLC | Pharmacy | 9830 Liberia Pharmacy, Manassas, VA 20110 | 2013-10-30 |
| 1689981482 | Harris Teeter, LLC | Pharmacy | 10060 Market Cir, Manassas, VA 20110-0000 | 2010-09-01 |
| 1407082043 | Walgreen Co | Pharmacy | 10671 Sudley Manor Dr, Manassas, VA 20109-2844 | 2009-06-10 |
| 1245340876 | Costco Wholesale Corporation | Pharmacy | 10701 Sudley Manor Dr, Manassas, VA 20109 | 2006-08-30 |
| 1407309099 | Adkoa Pharmacy LLC | Pharmacy | 8261 Shoppers Sq, Manassas, VA 20111-2176 | 2016-07-29 |
| 1972906212 | Prince William Hospital | Pharmacy | 8700 Sudley Rd, Manassas, VA 20110-4418 | 2014-10-01 |
| 1538202981 | Vithalla, LLC | Pharmacy | 8573 Sudley Rd Ste B, Manassas, VA 20110-3809 | 2007-02-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730788381 | Maysons Pharmacy At Retreat Inc | Pharmacy | 110 N Robinson St Ste 101, Richmond, VA 23220-4459 | 2020-10-23 |
| 1275156572 | Herbert T Nguyen | Pharmacy | 5100 Harford Ln, Burke, VA 22015-1510 | 2020-05-20 |
| 1932720174 | Warrington Wellness and Compounding Pharmacy | Pharmacy | 805 Kent Pl Ste 104, Chesapeake, VA 23320-0768 | 2020-04-28 |
| 1467081273 | Chungkang Pharmacy, LLC | Pharmacy | 14637 Lee Hwy # 109b, Centreville, VA 20121-5829 | 2020-04-03 |
| 1174151716 | Vandorn Apothecary LLC | Pharmacy | 5724 Edsall Rd Alexandria Va 22304, Alexandria, VA 22304-4712 | 2020-03-30 |
| 1528691946 | Pharmacy One LLC | Pharmacy | 14904 Jefferson Davis Hwy Ste 101, Woodbridge, VA 22191-3908 | 2020-02-13 |
| 1477193936 | Anderson & Payne Pharmacy Inc | Pharmacy | 16 Gosnell Xing Ste 101, Staunton, VA 24401-6344 | 2020-01-13 |
| 1245876531 | Farmville Family Pharmacy, Inc. | Pharmacy | 1538 South Main Street, Farmville, VA 23901 | 2019-11-21 |
| 1215578901 | Jtj Medical Supply, Inc. | Pharmacy | 1001 Monticello Ave, Norfolk, VA 23510-2564 | 2019-10-03 |
| 1659912889 | Aylin Unal | Pharmacy | 1409 Emmet St N, Charlottesville, VA 22903-4874 | 2019-09-29 |
| 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.