KMART CORPORATION (NPI# 1215968276) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215968276 |
| Entity Type | Organization |
| Organization Name | KMART CORPORATION |
| Other Organization Name | KMART PHARMACY4903 |
| Practice Address |
190 Stadium Dr Defiance OH 43512-4602 |
| Practice Telephone | 4197826044 |
| Practice Fax Number | 4197821703 |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2007-12-26 |
| Authorized Official Name | DALE PURVIS (DIRECTOR OF THIRD PARTY ADMIN) |
| Authorized Official Telephone | 8472862527 |
| 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 |
02756500 | OH | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 0942556 | 05 | |
| OTHER ID NUMBER-COMMERCIAL NUMBER | 3658765 | 01 | |
| OTHER ID NUMBER | 3658765 | 01 |
| Other Name | Type Code |
|---|---|
| KMART PHARMACY4903 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619299146 | Kmart Corporation | Pharmacy | 545 Concord Pkwy N, Concord, NC 28027-6738 | 2010-02-25 |
| 1952332066 | Kmart Corporation | Pharmacy | 2400 W 29th St, Greeley, CO 80631-8525 | 2006-07-06 |
| 1275564320 | Kmart Corporation | Pharmacy | 210 Saratoga Rd, Scotia, NY 12302-4509 | 2006-07-06 |
| 1700817707 | Kmart Corporation | Pharmacy | 2705 Parleys Way, Salt Lake City, UT 84109-1619 | 2006-07-06 |
| 1467483461 | Kmart Corporation | Pharmacy | 1547 Highway 59 S, Thief River Falls, MN 56701-3413 | 2006-07-06 |
| 1932130085 | Kmart Corporation | Pharmacy | 15 Park Ave Ste 22, Clifton Park, NY 12065-2924 | 2006-07-06 |
| 1083645048 | Kmart Corporation | Pharmacy | 2707 W Broadway St, Princeton, IN 47670-9420 | 2006-07-06 |
| 1306877428 | Kmart Corporation | Pharmacy | 175 N West State Rd, American Fork, UT 84003-1485 | 2006-07-06 |
| 1427089556 | Kmart Corporation | Pharmacy | 4855 Summit Ridge Dr, Reno, NV 89523-7936 | 2006-07-06 |
| 1669403713 | Kmart Corporation | Pharmacy | 1075 Middle Country Rd, Middle Island, NY 11953-2514 | 2006-07-06 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Vermont Business Registrations | KMART CORPORATION | 3333 Beverly Rd., Hoffman Estates, IL 60179 |
| Oklahoma Business Registrations | KMART CORPORATION | 3100 W. Big Beaver Rd., Troy, MI 48084 |
| Street Address |
190 STADIUM DR |
| City | DEFIANCE |
| State | OH |
| Zip Code | 43512-4602 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174098768 | Dr. Bradley Pittman Dds Ltd. | Oral & Maxillofacial Surgery | 205 E. Second St., Defiance, OH 43512 | 2018-10-10 |
| 1285115147 | Tamara Lynn Junge | Social Worker | 1252 Ralston Avenue, #401, Defiance, OH 43512 | 2018-08-28 |
| 1306207568 | Deborah Lehnert | Licensed Practical Nurse | 511 Perry Street, Defiance, OH 43512 | 2016-03-16 |
| 1265857924 | P & R Home Iv Service, Inc. | Durable Medical Equipment & Medical Supplies | 1018 Ralston Avenue, Suite 107, Defiance, OH 43512 | 2014-03-04 |
| 1609020155 | Christina Marie Pergram | Physician Assistant | 1250 Rlaston Ave, Suite 104, Defiance, OH 43512 | 2008-11-11 |
| 1477740785 | Assisted Living Concepts Inc | Assisted Living Facility | 245 North Rosewood Avenue, Defiance, OH 43512 | 2007-10-01 |
| 1720127863 | Kathy Williams Homier | Counselor | 815 E Second St, Defiance, OH 43512 | 2007-02-05 |
| 1407944960 | Oak Health Care Investors of Defiance, Inc. | Durable Medical Equipment & Medical Supplies | 1701 South Jefferson Ave, Defiance, OH 43512 | 2006-10-10 |
| 1184733719 | Shane Aaron Klingler | Chiropractor | 1770 Jefferson Ave, Defiance, OH 43512 | 2006-08-29 |
| 1396751327 | Elizabeth Marie Seibert | Pharmacist | 1245 E Second St, Defiance, OH 43512 | 2006-07-31 |
| Find all providers in zip 43512 | ||||
| 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 |
|---|---|---|---|---|
| 1295335024 | Hux Enterprises | Pharmacy | 641 Hill Rd N Ste C, Pickerington, OH 43147-9346 | 2020-10-30 |
| 1891302626 | Uc Healthcare System | Pharmacy | 222 Piedmont Ave Ste 2000, Cincinnati, OH 45219-4231 | 2020-09-25 |
| 1619580966 | Lcrg Bros LLC | Pharmacy | 7584 E Main St, Reynoldsburg, OH 43068-1208 | 2020-08-26 |
| 1528686763 | Lorain Chemists Inc | Pharmacy | 3815 Lorain Ave, Cleveland, OH 44113-3710 | 2020-07-13 |
| 1699397646 | D & G Partners LLC | Pharmacy | 7623 E Main St, Reynoldsburg, OH 43068-1209 | 2020-05-13 |
| 1992325567 | The Kroger Co | Pharmacy | 3255 Eden Ave, Suite 336, Cincinnati, OH 45229 | 2020-04-23 |
| 1689200461 | Cross Point Pharmacy | Pharmacy | 800 Cross Pointe Rd Ste P, Gahanna, OH 43230-6690 | 2020-03-12 |
| 1245870864 | Bravo Rx Pharmacy | Pharmacy | 4125 W Broad St # B, Columbus, OH 43228-1600 | 2020-01-11 |
| 1235777350 | Tan Thai Inc | Pharmacy | 4300 Clime Rd Ste 111, Columbus, OH 43228-6491 | 2019-12-19 |
| 1144868597 | Blanchard Valley Regional Health Center | Pharmacy | 930 Sheriden Dr Ste C, Carey, OH 43316-1502 | 2019-12-17 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on KMART CORPORATION.
| 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.