K MART CORP (NPI# 1104857267) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104857267 |
| Entity Type | Organization |
| Organization Name | K MART CORP |
| Other Organization Name | KMART PHARMACY4137 |
| Practice Address |
2701 Freedom Dr Charlotte NC 28208-3853 |
| Mailing Address |
3333 Beverly Rd Ac 367 B Hoffman Estates IL 60179-0001 |
| Practice Telephone | 7043994611 |
| Practice Fax Number | 7043922790 |
| Mailing Telephone | 8472864089 |
| Mailing Fax Number | 8472861603 |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2013-08-06 |
| Authorized Official Name | ELIZABETH ZANDER (DIRECTOR MANAGED CARE) |
| Authorized Official Telephone | 8472867661 |
| 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 |
09855 | NC | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 0602125 | 05 | |
| NC | 0607390 | 05 | |
| PK | 2068129 | 01 |
| Other Name | Type Code |
|---|---|
| KMART PHARMACY4137 | 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 |
2701 FREEDOM DR |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28208-3853 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205023108 | Jamie Liszka Pope | Pharmacist | 2701 Freedom Dr, Charlotte, NC 28208-3853 | 2007-09-25 |
| 1396972105 | John Winfield Cline | Pharmacist | 2701 Freedom Dr, Charlotte, NC 28208-3853 | 2009-06-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124645544 | Charlotte Sp Senior Housing Opco, LLC | Custodial Care Facility | 6041 Piedmont Row Drive, Charlotte, NC 28208 | 2020-07-01 |
| 1750929659 | Tru Pearl Solution Services Pllc | Community/Behavioral Health | 2128 Remount Road Suite B, Charlotte, NC 28208 | 2019-12-11 |
| 1245880699 | Camilla A Raley | Technician | 1539 Walton Rd, Charlotte, NC 28208 | 2019-09-18 |
| 1912567041 | Nolan Scott Blake | In Home Supportive Care | 4926 Ridgeley Dr., Suite B, Charlotte, NC 28208 | 2019-06-20 |
| 1699244145 | Catalyst Chiropractic, Pllc | Chiropractor | 2620 Tuckaseegee Rd., Charlotte, NC 28208 | 2018-11-14 |
| 1255854691 | Jessica Lynne Hunter | Social Worker | 2011 Water Walk Lane Apt 209, Charlotte, NC 28208 | 2017-07-18 |
| 1700311420 | Matthew Christian Mundorf | Chiropractor | 2620 Tuckaseegee Rd, Charlotte, NC 28208 | 2017-05-01 |
| 1700235439 | Erin Merchant | Counselor | 2016 Millerton Avenue, #2213, Charlotte, NC 28208 | 2016-06-03 |
| 1528432564 | Monika Sheree Moore | Counselor | 3205 Freedom Dr, Charlotte, NC 28208 | 2015-11-13 |
| 1205224540 | Phadality Home Care | Home Health | 201 S Hoskins Rd., Suite 119, Charlotte, NC 28208 | 2015-01-08 |
| Find all providers in zip 28208 | ||||
| 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 |
|---|---|---|---|---|
| 1245847599 | Western Brothers LLC | Pharmacy | 1943 E 7th St, Charlotte, NC 28204-2417 | 2020-09-29 |
| 1770121998 | Capsule Charlotte LLC | Pharmacy | 2041 South Blvd Ste 103, Charlotte, NC 28203-5775 | 2019-12-18 |
| 1821631672 | Healthy Living Pharmacy | Pharmacy | 3717 N. Sharon Amity Road, Suite C, Charlotte, NC 28205 | 2019-10-24 |
| 1861957292 | Oakhurst Health Investers Inc. | Pharmacy | 1630 Oakhurst Commons Dr, Unit 206, Charlotte, NC 28205 | 2019-02-11 |
| 1720576085 | D&d Pharmacy LLC | Pharmacy | 2903 Central Ave Ste A, Charlotte, NC 28205-6073 | 2018-04-23 |
| 1609302173 | Charlotte Family Pharmacy | Pharmacy | 7008 E Wt Harris Blvd Ste 4, Charlotte, NC 28215-4298 | 2017-05-03 |
| 1316483472 | Health Saver Rx, LLC | Pharmacy | 3809 Beam Road Suite H, Suite H, Charlotte, NC 28217 | 2017-01-13 |
| 1396195913 | Rxcp2 | Pharmacy | 6010 E W T Harris Blvd, Charlotte, NC 28215-4084 | 2016-06-14 |
| 1396146452 | Genoa Healthcare, LLC | Pharmacy | 5700 Executive Center Dr Ste 216, Charlotte, NC 28212-8833 | 2014-09-09 |
| 1245630706 | Walgreens Co. | Pharmacy | 2720 South Blvd, Apt 122, Charlotte, NC 28209-0004 | 2014-09-02 |
| Find all providers in CHARLOTTE | ||||
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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.