KMART OF MICHIGAN INC (NPI# 1134150121) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134150121 |
| Entity Type | Organization |
| Organization Name | KMART OF MICHIGAN INC |
| Other Organization Name | KMART PHARMACY4488 |
| Practice Address |
1100 S Rochester Rd Rochester Hills MI 48307-3114 |
| Mailing Address |
3333 Beverly Rd Ac 367 B Hoffman Estates IL 60179-0001 |
| Practice Telephone | 2486529480 |
| Practice Fax Number | 2486010396 |
| Mailing Telephone | 8472864089 |
| Mailing Fax Number | 8472861603 |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2014-10-30 |
| Authorized Official Name | DAIN RUSK (VP/GM PHARMACY) |
| Authorized Official Telephone | 8472863348 |
| 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 |
5301004873 | MI | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 2530383 | 05 | |
| PK | 2041539 | 01 |
| Other Name | Type Code |
|---|---|
| KMART PHARMACY4488 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114353919 | Kmart of Michigan Inc | Pharmacy | 2425 S I 75 Business Loop, Grayling, MI 49738-2042 | 2013-09-25 |
| 1609984095 | Kmart of Michigan Inc | Pharmacy | 1151 S Otsego Ave # A, Gaylord, MI 49735-1789 | 2006-08-27 |
| 1760413751 | Kmart of Michigan Inc | Pharmacy | 2500 E M21, Corunna, MI 48817 | 2006-07-06 |
| 1700817780 | Kmart of Michigan Inc | Pharmacy | 19800 West Rd, Woodhaven, MI 48183-3319 | 2006-07-06 |
| 1609807692 | Kmart of Michigan Inc | Pharmacy | 6730 River Rd, Marine City, MI 48039-2284 | 2006-07-06 |
| 1538190517 | Kmart of Michigan Inc | Pharmacy | 100 E Maple Rd, Troy, MI 48083-2714 | 2006-07-06 |
| 1457382434 | Kmart of Michigan Inc | Pharmacy | 215 N Maple Rd, Ann Arbor, MI 48103-2823 | 2006-07-06 |
| 1538190525 | Kmart of Michigan Inc | Pharmacy | 710 Chicago Dr, Holland, MI 49423-3074 | 2006-07-06 |
| 1750312740 | Kmart of Michigan Inc | Pharmacy | 17580 Frazho Rd, Roseville, MI 48066-3829 | 2006-07-06 |
| 1336170323 | Kmart of Michigan Inc | Pharmacy | 2948 S State Rd, Ionia, MI 48846-9475 | 2006-07-06 |
| Street Address |
1100 S ROCHESTER RD |
| City | ROCHESTER HILLS |
| State | MI |
| Zip Code | 48307-3114 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023168374 | Cole Vision Corporation | Eyewear Supplier (Equipment, not the service) | 1100 S Rochester Rd, Rochester Hills, MI 48307-3114 | 2007-01-11 |
| 1265755458 | Denise Anne Yankovich | Pharmacist | 1100 S Rochester Rd, Rochester Hills, MI 48307-3114 | 2010-03-02 |
| 1083946271 | Doaa A Sakr | Pharmacist | 1100 S Rochester Rd, Rochester Hills, MI 48307-3114 | 2010-02-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083238851 | Martin Dukaj | Student in an Organized Health Care Education/Training Program | 1101 Walton Blvd, Rochester Hills, MI 48307 | 2020-06-08 |
| 1073151973 | Cynthia Lynn Olekszyk | Dietitian, Registered | 645 Barclay Circle, Rochester Hills, MI 48307 | 2019-12-11 |
| 1326502428 | Jessica Delia | Nurse Practitioner | 1701 E South Boulevard, Suite 290, Rochester Hills, MI 48307 | 2019-01-23 |
| 1528530037 | Kelie Friday | Physical Therapist | 312 Rochester Hills, Dearborn, MI 48307 | 2018-12-21 |
| 1538635883 | Julie Latarewicz | Physical Therapist | Ascension Providence Rochester Hospital, 1101 West University Drive, Rochester, MI 48307 | 2018-10-15 |
| 1891270757 | Leah Marx | Social Worker | 3950 Rochester Rd, Ste 2250, Rochester Hills, MI 48307 | 2018-09-26 |
| 1598256729 | Frederick Alan Bittner | Student in an Organized Health Care Education/Training Program | 1101 W. University Drive, 3 North, Rochester, MI 48307 | 2018-05-23 |
| 1508356346 | Ankita Aggarwal | Student in an Organized Health Care Education/Training Program | Wsu/ascension Crittenton Hospital, 1101 W. University Drive, Rochester, MI 48307 | 2018-05-17 |
| 1619478195 | Michelle Nuccio | Occupational Therapist | 1555 E South Blvd, Rochester Hills, MI 48307 | 2018-02-21 |
| 1265932024 | Stacy Dietlin Linn | Physical Therapist | 1555 E. South Blvd, Suite 120, Rochester Hills, MI 48307 | 2018-02-19 |
| Find all providers in zip 48307 | ||||
| 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 |
|---|---|---|---|---|
| 1851831481 | Sma Patient Care LLC | Pharmacy | 2708 S Rochester Rd Ste 204, Rochester Hills, MI 48307-4577 | 2017-03-01 |
| 1669890034 | Auburn Pharmacy | Pharmacy | 2040 W Auburn Rd, Rochester Hills, MI 48309-3628 | 2014-04-02 |
| 1154688109 | Thera Script Rochester | Pharmacy | 455 Barclay Cir # C-2, Rochester Hills, MI 48307-4774 | 2012-04-16 |
| 1306948641 | Woodward Detroit Cvs, L.L.C. | Pharmacy | 295 S Livernois Rd, Rochester Hills, MI 48307-1838 | 2006-09-05 |
| 1629180559 | Woodward Detroit Cvs, L.L.C. | Pharmacy | 981 E Auburn Rd, Rochester Hills, MI 48307-5310 | 2006-08-31 |
| 1205948148 | Woodward Detroit Cvs, L.L.C. | Pharmacy | 3010 Walton Blvd, Rochester Hills, MI 48309-1264 | 2006-08-31 |
| 1164074449 | Lakshmi Pharmacy Enterprises, LLC | Pharmacy | 6700 N Rochester Rd Ste 101, Rochester Hills, MI 48306-4378 | 2019-07-16 |
| 1518382860 | Tri-star Pharmacy LLC | Pharmacy | 2840 Crooks Rd, Suite 400, Rochester Hills, MI 48309-3676 | 2014-02-24 |
| 1528352978 | Pharmacare Pharmacy LLC | Pharmacy | 1460 Walton Blvd, Suite # 90, Rochester Hills, MI 48309-1768 | 2011-06-02 |
| 1508194598 | Gia Pharmacy Inc | Pharmacy | 75 Barclay Cir, Suite 114, Rochester Hills, MI 48307-5820 | 2009-12-02 |
| Find all providers in ROCHESTER HILLS | ||||
| City | ROCHESTER HILLS |
| Zip Code | 48307 |
Please comment or provide details below to improve the information on KMART OF MICHIGAN INC.
| 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.