KMART OF WASHINGTON LLC (NPI# 1215968342) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215968342 |
| Entity Type | Organization |
| Organization Name | KMART OF WASHINGTON LLC |
| Other Organization Name | KMART PHARMACY3389 |
| Practice Address |
4141 Martin Way E Lacey WA 98516-5351 |
| Mailing Address |
3333 Beverly Rd Ac 367 B Hoffman Estates IL 60179-0001 |
| Practice Telephone | 3609239344 |
| Practice Fax Number | 3604553196 |
| Mailing Telephone | 8472864089 |
| Mailing Fax Number | 8477471553 |
| 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 |
CF00057825 | WA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 6012058 | 05 | |
| NCPDP PROVIDER IDENTIFICATION NUMBER | 4921284 | 01 |
| Other Name | Type Code |
|---|---|
| KMART PHARMACY3389 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124059258 | Kmart of Washington LLC | Pharmacy | 1414 72nd St E, Tacoma, WA 98404-3307 | 2006-07-06 |
| 1760413892 | Kmart of Washington LLC | Pharmacy | 13200 Aurora Ave N, Seattle, WA 98133-7509 | 2006-07-06 |
| 1689605719 | Kmart of Washington LLC | Pharmacy | 2711 Ne Andresen Rd, Vancouver, WA 98661-7317 | 2006-07-06 |
| 1942231071 | Kmart of Washington LLC | Pharmacy | 32165 State Route 20, Oak Harbor, WA 98277-3774 | 2006-07-06 |
| 1043564040 | Kmart of Washington LLC | Durable Medical Equipment & Medical Supplies | 3333 Beverly Rd, Bc 259 Aa, Hoffman Estates, IL 60179-0001 | 2012-10-30 |
| 1033140165 | Kmart of Washington LLC | Pharmacy | 1201 Nw Louisiana Ave, Chehalis, WA 98532-1816 | 2006-07-06 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | KMART OF WASHINGTON LLC | 3333 Beverly Rd, Hoffman Estates, IL 60179 |
| Street Address |
4141 MARTIN WAY E |
| City | LACEY |
| State | WA |
| Zip Code | 98516-5351 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730744210 | Michael Oropeza | Behavioral Analyst | 8282 28th Court Northeast, Suite A, Lacey, WA 98516 | 2019-05-09 |
| 1902361330 | Amanda Jessica Mae Allen | Behavioral Analyst | Basics Nw LLC, 8282 28th Ct Ne Suite A, Lacey, WA 98516 | 2019-02-11 |
| 1619459393 | Kayla-renee Williams | Behavioral Analyst | Basics Nw LLC 8282 28th Ct Ne, Suite A, Lacey, WA 98516 | 2018-08-30 |
| 1174004303 | Julie Ann Lisowski | Massage Therapist | 3532 Cuddy Ln Ne, Lacey, WA 98516 | 2018-08-26 |
| 1740700145 | Joseph Brandon Kimmel | Denturist | 5032 Beverly Dr Ne, Olympia, WA 98516 | 2017-06-27 |
| 1649649880 | Katie Cole | Behavioral Analyst | 8282 28th Ct Ne, Suite A, Basics Nw, LLC, Lacey, WA 98516 | 2015-09-17 |
| 1306234166 | Reza Tahernia | Dentist | 8050 Freedon Lane Ne, Suite C, Lacey, WA 98516 | 2015-01-02 |
| 1770997603 | Qualified Surgical Services Pllc | Surgery | 3697 Cameron Dr Ne, Lacey, WA 98516 | 2014-06-18 |
| 1184048688 | Stephanie Renee Hjortedal | Specialist/Technologist | 8750 Tallon Lane Ne., Lacey, WA 98516 | 2014-02-05 |
| 1295169811 | Teasha Corrado | Behavioral Analyst | 8282 28th Court Ne, Suite A, Lacey, WA 98516 | 2013-08-30 |
| Find all providers in zip 98516 | ||||
| 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 |
|---|---|---|---|---|
| 1700996352 | Costco Wholesale Corporation | Pharmacy | 1470 Marvin Rd Ne, Lacey, WA 98516 | 2006-08-30 |
| 1235162579 | Haggen Inc | Pharmacy | 5600 Martin Way E, Lacey, WA 98516-6308 | 2006-07-09 |
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|---|---|---|---|---|
| 1700493533 | Doctors Pharmacy, LLC | Pharmacy | 65 Columbia Point Dr, Richland, WA 99352-4375 | 2020-09-25 |
| 1871105999 | Whidbey Island Public Hospital District | Pharmacy | 7 Ne Birch St, Coupeville, WA 98239-3132 | 2020-08-19 |
| 1710504550 | Kayshuv Enterprises | Pharmacy | 7505 Sandifur Pkwy, Suite 102, Pasco, WA 99301 | 2020-06-27 |
| 1811511454 | Kaiser Foundation Health Plan of Washington | Pharmacy | 189 Telegraph Rd, Bellingham, WA 98226-8079 | 2020-05-29 |
| 1548883630 | Capsule Seattle LLC | Pharmacy | 2033 6th Ave Ste 120, Seattle, WA 98121-2526 | 2020-05-22 |
| 1063048197 | Peninsula Pharmacies Inc Long Beach Pharmacy Annex | Pharmacy | 110 Oregon Ave S, Long Beach, WA 98631 | 2020-03-20 |
| 1174155345 | Kaiser Foundation Health Plan of Washington | Pharmacy | 2335 172nd Street Ne, Marysville, WA 98271 | 2020-02-06 |
| 1245861996 | Salish Integrative Medicine, Inc | Pharmacy | 3700 Pacific Hwy E Ste 100b, Fife, WA 98424-1160 | 2020-01-31 |
| 1700417854 | Prosser Southgate Pharmacy Inc | Pharmacy | 207 Canyon Drive, Prosser, WA 99350-1009 | 2020-01-28 |
| 1700423639 | Venkateswara LLC | Pharmacy | 515 Minor Ave Ste 120, Seattle, WA 98104-2138 | 2019-12-10 |
| Find all providers with the same taxonomy | ||||
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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.