K MART CORP (NPI# 1104857259) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104857259 |
| Entity Type | Organization |
| Organization Name | K MART CORP |
| Other Organization Name | KMART PHARMACY4450 |
| Practice Address |
4500 Western Blvd Raleigh NC 27606-1834 |
| Mailing Address |
3333 Beverly Rd Ac 367 B Hoffman Estates IL 60179-0001 |
| Practice Telephone | 9198515247 |
| Practice Fax Number | 9198594357 |
| Mailing Telephone | 8472864089 |
| Mailing Fax Number | 8472861603 |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2015-02-04 |
| Authorized Official Name | JENNIFER SPEARES (DIR. OF COMPLIANCE AND ADMIN.) |
| Authorized Official Telephone | 8472865116 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
09875 | NC | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 0926873 | 05 | |
| NC | 0920099 | 05 | |
| PK | 2067894 | 01 |
| Other Name | Type Code |
|---|---|
| KMART PHARMACY4450 | 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 |
4500 WESTERN BLVD |
| City | RALEIGH |
| State | NC |
| Zip Code | 27606-1834 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609056720 | Wendy Ann Hagwood | Pharmacist | 4500 Western Blvd, Kmart Pharmacy #4450, Raleigh, NC 27606-1814 | 2007-11-06 |
| 1194182451 | Christy Lee | Pharmacist | 4500 Western Blvd, Raleigh, NC 27606-1834 | 2016-01-18 |
| 1821340340 | Nutan Nitin Sheth | Pharmacist | 4500 Western Blvd, Raleigh, NC 27606-1834 | 2012-10-08 |
| 1417186131 | Angela Alston | Pharmacist | 4500 Western Blvd, Raleigh, NC 27606-1814 | 2009-07-02 |
| 1720221419 | New Beginning | Counselor | 4500 Western Blvd, Raleigh, NC 27606-1814 | 2009-04-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831716703 | Bright Chukwemeka Igwe | Counselor | 4909 Waters Edge Drive Suite 203, 4909 Waters Edge Dr. Suite 203, Raleigh, NC 27606 | 2020-06-26 |
| 1083250831 | The Lee Way Therapy & Consulting, Pllc | Social Worker | 4909 Waters Edge Dr., Suite 200a, Raleigh, NC 27606 | 2019-11-26 |
| 1811455488 | Inimfon E Ubom | Student in an Organized Health Care Education/Training Program | 521 The Greens Cir Apt 242, Raleigh, NC 27606 | 2019-03-03 |
| 1326550658 | Care Advantage-north Carolina LLC | Registered Nurse | 3231 Avent Ferry Rd Ste 103, Raleigh, NC 27606 | 2017-10-26 |
| 1801348891 | John Riel Manalansan Garcia | Specialist/Technologist | 2411 Dunn Ave, Raleigh, NC 27606 | 2016-10-26 |
| 1134599889 | Klingensmith & Associates, Pllc | Dentist | 1009 Capability Dr., Bldg. II. Ste 100, Raleigh, NC 27606 | 2015-10-06 |
| 1487038626 | Turning Leaf Therapy Services, Pllc | Social Worker | 4909 Waters Edge Drive 200d, Raleigh, NC 27606 | 2015-07-17 |
| 1528448743 | Ashley Francis Wright | Counselor | 1601 Jones Franklin Road, Suite 104, Raleigh, NC 27606 | 2015-06-03 |
| 1598172645 | Amalya Kali Wright | Emergency Medical Technician, Basic | 5315 Dana Dr Apt F, Raleigh, NC 27606 | 2014-07-21 |
| 1710312566 | Deirdre Rushin | Counselor | 1821 Avent Ridge Rd, Apt 104, Raleigh, NC 27606 | 2013-09-12 |
| Find all providers in zip 27606 | ||||
| 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 |
|---|---|---|---|---|
| 1366073777 | Medly Raleigh Inc. | Pharmacy | 3029 Capital Blvd Ste 105, Raleigh, NC 27604-3377 | 2020-02-04 |
| 1184264897 | Springfield Pharmacy LLC | Pharmacy | 6325 Falls of Neuse Rd Ste 65, Raleigh, NC 27615-6884 | 2020-01-10 |
| 1972146967 | Atlantic Avenue Pharmaceutical, Inc | Pharmacy | 5621 Atlantic Ave, Suite 103, Raleigh, NC 27615 | 2019-10-22 |
| 1639646532 | Oakridge Rx LLC | Pharmacy | 2406 Blue Ridge Rd Ste 180, Raleigh, NC 27607-6692 | 2018-10-29 |
| 1093258295 | U.S. Pharmamed, LLC | Pharmacy | 3450 Tarheel Dr., Ste #101 Bldg. 4, Attn: Licensing, Raleigh, NC 27609 | 2016-11-21 |
| 1821465568 | North Carolina Cvs Pharmacy LLC | Pharmacy | 3001 Hillsborough St, Suite 100, Raleigh, NC 27607-5434 | 2015-08-28 |
| 1073909701 | Onerx, LLC | Pharmacy | 8490 Honeycutt Rd, Suite 103, Raleigh, NC 27615-2262 | 2015-04-09 |
| 1831587476 | Harris Teeter LLC | Pharmacy | 2051 W Millbrook Road, Raleigh, NC 27612 | 2015-01-06 |
| 1780072975 | Harris Teeter LLC | Pharmacy | 2051 W. Millbrook Road, Raleigh, NC 27612 | 2014-12-23 |
| 1346657129 | Morgan Street Pharmacy LLC | Pharmacy | 927 W Morgan St, Ste 100, Raleigh, NC 27603-1600 | 2014-07-14 |
| Find all providers in RALEIGH | ||||
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.