TRANSFORM KM LLC (NPI# 1225069362) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225069362 |
| Entity Type | Organization |
| Organization Name | TRANSFORM KM LLC |
| Other Organization Name | KMART PHARMACY #3088 |
| Practice Address |
4100 52nd St Kenosha WI 53144-3900 |
| Mailing Address |
3333 Beverly Rd Bc 260 A Hoffman Estates IL 60179-0001 |
| Practice Telephone | 2626580902 |
| Practice Fax Number | 8473962527 |
| Mailing Telephone | 8472864089 |
| Mailing Fax Number | 8477471553 |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2019-05-08 |
| Authorized Official Name | JENNIFER SPEARES LEHMAN (HEAD OF PHARMACY) |
| Authorized Official Telephone | 8472865116 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
6083-42 | WI | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 33014500 | 05 | |
| PK | 2113873 | 01 |
| Other Name | Type Code |
|---|---|
| KMART PHARMACY #3088 | Doing Business As Name - Organization |
| KMART PHARMACY3088 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295041341 | Transform Km LLC | Pharmacy | 3333 Beverly Rd # Bc260a, Hoffman Estates, IL 60179-0001 | 2010-08-27 |
| 1396947248 | Transform Km LLC | Durable Medical Equipment & Medical Supplies | 250 W 34th St, New York, NY 10119-2152 | 2007-06-04 |
| 1700817772 | Transform Km LLC | Durable Medical Equipment & Medical Supplies | 18 Mark Plz, Kingston, PA 18704-3104 | 2006-07-06 |
| 1295766285 | Transform Km LLC | Durable Medical Equipment & Medical Supplies | 1 K Mart Plz, Greenville, SC 29605-4442 | 2006-07-06 |
| 1134150287 | Transform Km LLC | Durable Medical Equipment & Medical Supplies | 1815 21st St, Lewiston, ID 83501-4103 | 2006-07-06 |
| 1659302636 | Transform Km LLC | Durable Medical Equipment & Medical Supplies | 328 Ennis Ln, Towanda, PA 18848-9212 | 2006-07-06 |
| 1649201781 | Transform Km LLC | Durable Medical Equipment & Medical Supplies | 770 Broadway, New York, NY 10003-9522 | 2006-07-06 |
| 1053342030 | Transform Km LLC | Pharmacy | Pr 149 Y 584, Plaza Juana Diaz, Juana Diaz, PR 00795 | 2006-07-06 |
| 1699706689 | Transform Km LLC | Durable Medical Equipment & Medical Supplies | Pr 2 Km 29.7, Centro Gran Caribe 16 II, Vega Alta, PR 00692 | 2006-07-06 |
| 1073544136 | Transform Km LLC | Durable Medical Equipment & Medical Supplies | 1209 Russ Ave, Waynesville, NC 28786-2947 | 2006-07-06 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | TRANSFORM KM LLC | 3333 Beverly Rd, Hoffman Estates, IL 60179 |
| Washington State Corporations | TRANSFORM KM LLC | 3333 Beverly Road, Hoffman Estates, IL 60179 |
| New York State Corporations | TRANSFORM KM LLC | 28 Liberty Street, New York, New York 10005 |
| Iowa Business Entities | TRANSFORM KM LLC | 1170 Kane Concourse, Suite 200, Bay Harbor Islands, FL 33154 |
| Virginia Business Entities | Transform KM LLC | 3333 Beverly Rd, Hoffman Estates, Illinois 60179-0001 |
| Connecticut Business Registrations | TRANSFORM KM LLC | 3333 Beverly Road, Hoffman Estates, IL 60179 |
| Street Address |
4100 52ND ST |
| City | KENOSHA |
| State | WI |
| Zip Code | 53144-3900 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225690985 | Ryan Taylor Billman | Pharmacist | 4100 52nd St, Kenosha, WI 53144-3999 | 2019-07-02 |
| 1891158440 | Sears Holdings Corporation | Pharmacy | 4100 52nd St, Kenosha, WI 53144-3900 | 2016-03-31 |
| 1265754485 | Yelena Ivanova | Pharmacist | 4100 52nd St, Kenosha, WI 53144-3900 | 2010-02-16 |
| 1669794889 | Michelle Renee Clements | Pharmacist | 4100 52nd St, Kenosha, WI 53144-3900 | 2010-02-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902410202 | Dpt Holdings LLC | Occupational Therapist | 3825 39th Ave #110, Kenosha, WI 53144 | 2020-09-03 |
| 1225641392 | Eunice Boatin | Social Worker | Kenosha Human Development Services, 3536 52nd Street, Kenosha, WI 53144 | 2020-08-28 |
| 1881250256 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 3621 Market Lane, Kenosha, WI 53144 | 2019-05-11 |
| 1124540067 | Kaitlyn King | Speech-Language Pathologist | 5219 88th Ave., Kenosha, WI 53144 | 2017-07-12 |
| 1174992721 | Claire Ann Adams | Acupuncturist | 5416 52nd Street, Kenosha, WI 53144 | 2015-09-24 |
| 1285017087 | Jessica Lynn Gillengerten | Acupuncturist | 4235 Green Bay Rd., Suite #10, Kenosha, WI 53144 | 2015-06-30 |
| 1750704656 | Amanda Kay Kreuzer | Occupational Therapy Assistant | 3109 30th Ave, Kenosha, WI 53144 | 2014-01-28 |
| 1841626785 | B7 Pharmacy Inc | Pharmacy | 3825 39th Ave Ste 100, Kenosha, WI 53144 | 2013-09-24 |
| 1124326764 | Wisconsin Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 3710 57th Ave, Kenosha, WI 53144 | 2011-03-07 |
| 1982931291 | Roman Bilak | General Practice | 4126 - 7th Street, Kemosha, WI 53144 | 2009-11-06 |
| Find all providers in zip 53144 | ||||
| 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 |
|---|---|---|---|---|
| 1841626785 | B7 Pharmacy Inc | Pharmacy | 3825 39th Ave Ste 100, Kenosha, WI 53144 | 2013-09-24 |
| 1295014959 | Roundys Supermarkets Inc | Pharmacy | 2811 18th St, Kenosha, WI 53140-4665 | 2011-08-12 |
| 1891843157 | Roundys Supermarkets Inc | Pharmacy | 1901 63rd St, Kenosha, WI 53143-4467 | 2007-01-05 |
| 1285704890 | B7 Pharmacy, Inc. | Pharmacy | 3207 80th St, Suite 100, Kenosha, WI 53142-4908 | 2006-11-09 |
| 1356358238 | Walgreen Co | Pharmacy | 3805 80th St, Kenosha, WI 53142-4951 | 2006-08-02 |
| 1760497812 | Walgreen Co | Pharmacy | 3820 52nd St, Kenosha, WI 53144-2624 | 2006-07-29 |
| 1114951332 | Aurora Pharmacy Inc | Pharmacy | 7540 22nd Ave, Kenosha, WI 53143-5702 | 2006-07-11 |
| 1073554945 | Wisconsin Cvs Pharmacy LLC | Pharmacy | 2207 80th St, Kenosha, WI 53143-5756 | 2006-06-09 |
| 1174564041 | Wisconsin Cvs Pharmacy LLC | Pharmacy | 3726 22nd Ave, Kenosha, WI 53140-5300 | 2006-06-09 |
| 1891158440 | Sears Holdings Corporation | Pharmacy | 4100 52nd St, Kenosha, WI 53144-3900 | 2016-03-31 |
| Find all providers in KENOSHA | ||||
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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.