KMART OF MICHIGAN INC (NPI# 1205867298) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205867298 |
| Entity Type | Organization |
| Organization Name | KMART OF MICHIGAN INC |
| Other Organization Name | KMART PHARMACY7249 |
| Practice Address |
50700 Gratiot Ave Chesterfield MI 48051-3131 |
| Mailing Address |
3333 Beverly Rd Ac 367 B Hoffman Estates IL 60179-0001 |
| Practice Telephone | 5869496150 |
| Practice Fax Number | 5869496575 |
| Mailing Telephone | 8472864089 |
| Mailing Fax Number | 8472861603 |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2012-02-10 |
| 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 |
5301004866 | MI | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NCPDP PROVIDER IDENTIFICATION NUMBER | 2328917 | 01 | |
| MI | 2536707 | 05 |
| Other Name | Type Code |
|---|---|
| KMART PHARMACY7249 | 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 |
50700 GRATIOT AVE |
| City | CHESTERFIELD |
| State | MI |
| Zip Code | 48051-3131 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912239161 | Yvonne Yu Burch | Pharmacist | 50700 Gratiot Ave, Chesterfield, MI 48051-3131 | 2010-02-12 |
| 1811211311 | William Patrick Kiley Jr. | Pharmacist | 50700 Gratiot Ave, Chesterfield, MI 48051-3131 | 2010-03-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083139877 | Courtney Lynn Wittfeldt | Nurse Practitioner | 48833 Shady Glen Dr, Chesterfield, MI 48051 | 2017-08-14 |
| 1477082972 | Kathryn Louise Bruhns Zemke | Behavior Technician | 53869 Connor Drive, Chesterfield, MI 48051 | 2017-06-08 |
| 1417352055 | Julie Yaroch | Counselor | 51629 Hale Lane, Chesterfield Twp., MI 48051 | 2014-10-24 |
| 1437579661 | Jennifer Groeneveld | Physical Therapist | 34095 23 Mile Road, Chesterfield, MI 48051 | 2014-04-28 |
| 1376874396 | Donna Sue Perkins | Counselor | 50630 Chesterfield Road, Chesterfield, MI 48051 | 2010-01-15 |
| 1134267016 | Gary Main Burnett | Counselor | 46360 Gratiot Ave., Chesterfield, MI 48051 | 2007-02-02 |
| 1003831660 | Bormans Inc | Pharmacy | 51328 Gratiot, Chesterfield Twp, MI 48051 | 2006-07-13 |
| 1447228168 | Stephanie Lynn Denner | Occupational Therapist | 47085 Gratiot, Ceterfield, MI 48051 | 2006-03-09 |
| 1821077827 | Kathleen Marie-sohn Kudzia | Counselor | 46360 Gratiot, Chesterfield, MI 48051 | 2006-01-10 |
| 1366904708 | Tmj & Sleep Therapy Centre of Macomb County, Pllc | Dentist | 50475 Gratiot, Suite 4, Chesterfield, MI 48051 | 2019-04-04 |
| Find all providers in zip 48051 | ||||
| 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 |
|---|---|---|---|---|
| 1518318203 | Experiencedrx LLC | Pharmacy | 700 Crown Industrial Ct, Suite N and O, Chesterfield, MO 63005-1128 | 2016-06-24 |
| 1891027769 | Forum Rx Inc | Pharmacy | 106b Four Seasons Shopping Center, Chesterfield, MO 63017-3157 | 2010-02-03 |
| 1730311432 | Bridges & James Inc | Pharmacy | 107 West Blvd, Chesterfield, SC 29709-1528 | 2009-08-13 |
| 1932241320 | Forum Center Pharmacy Inc | Pharmacy | 67 Forum Shopping Center, Chesterfield, MO 63017-3006 | 2007-02-13 |
| 1184723488 | Woodward Detroit Cvs, L.L.C. | Pharmacy | 47011 Gratiot Ave, Chesterfield, MI 48051-2761 | 2006-09-22 |
| 1164521464 | Woodward Detroit Cvs, L.L.C. | Pharmacy | 52950 Gratiot Ave, Chesterfield, MI 48051-2046 | 2006-09-22 |
| 1740384411 | Virginia Cvs Pharmacy, L.L.C. | Pharmacy | 6400 Centralia Rd, Chesterfield, VA 23832-6523 | 2006-09-12 |
| 1790897643 | Woodward Detroit Cvs, L.L.C. | Pharmacy | 33920 23 Mile Rd, Chesterfield, MI 48047-4005 | 2006-08-31 |
| 1548264591 | Eversana Life Science Services, LLC | Pharmacy | 17877 Chesterfield Airport Rd, Chesterfield, MO 63005-1211 | 2005-06-08 |
| 1770985905 | Eversana Life Science Services, LLC | Pharmacy | 17877 Chesterfield Airport Rd, Chesterfield, MO 63005-1211 | 2014-09-18 |
| Find all providers in CHESTERFIELD | ||||
| City | CHESTERFIELD |
| Zip Code | 48051 |
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.