K MART CORP (NPI# 1255362257) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255362257 |
| Entity Type | Organization |
| Organization Name | K MART CORP |
| Other Organization Name | KMART PHARMACY4159 |
| Practice Address |
4670 S 900 E Salt Lake City UT 84117-4802 |
| Mailing Address |
3333 Beverly Rd Ac 367 B Hoffman Estates IL 60179-0001 |
| Practice Telephone | 8012632484 |
| Practice Fax Number | 8012650613 |
| Mailing Telephone | 8472864089 |
| Mailing Fax Number | 8472861603 |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2015-02-05 |
| Authorized Official Name | JENNIFER SPEARES (DIR. OF COMPLIANCE AND ADMIN.) |
| Authorized Official Telephone | 8472865116 |
| 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 |
1256981703 | UT | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2107835 | 01 |
| Other Name | Type Code |
|---|---|
| KMART PHARMACY4159 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841621695 | K Mart Corp | Pharmacy | 25 W Polk St, Coalinga, CA 93210-2366 | 2013-12-04 |
| 1437397411 | K Mart Corp | Pharmacy | Carr. Pr-156 Km 54.00, Las Catalinas Mall, Local 4858, Caguas, PR 00726 | 2009-01-28 |
| 1336256007 | K Mart Corp | Pharmacy | 3625 E 18th St, Antioch, CA 94509-8511 | 2006-08-25 |
| 1205943974 | K Mart Corp | Pharmacy | 1050 N Davis Rd, Salinas, CA 93907-1944 | 2006-08-25 |
| 1437177102 | K Mart Corp | Pharmacy | 5665 Rosemead Blvd, Temple City, CA 91780-1804 | 2006-07-18 |
| 1154352284 | K Mart Corp | Pharmacy | Rte 12 A, West Lebanon, NH 03784 | 2006-07-06 |
| 1093746117 | K Mart Corp | Pharmacy | 1501 Us 1, Vero Beach, FL 32960-5735 | 2006-07-06 |
| 1417988486 | K Mart Corp | Pharmacy | 1581 Us 68, Maysville, KY 41056-9178 | 2006-07-06 |
| 1902837040 | K Mart Corp | Pharmacy | Route 70 E, Marlton, NJ 08053 | 2006-07-06 |
| 1780615815 | K Mart Corp | Pharmacy | 129 Mall Rd, Covington, VA 24426-2413 | 2006-07-06 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | K MART CORPORATION | 3333 Beverly Road, Hoffman Estates, IL 60179 |
| Iowa Business Entities | K MART CORPORATION | 3333 Beverly Road, Hoffman Estates, IL 60179 |
| Connecticut Business Registrations | K MART CORPORATION | 3333 Beverly Road, Hoffman Estates, IL 60179 |
| Oregon Corporations, Companies and Business Names | K MART CORPORATION | 3333 Beverly Rd, Hoffman Estates, IL 60179 |
| Virginia Business Entities | K MART CORPORATION | 3333 Beverly Rd, Hoffman Estates, Illinois 60179 |
| New York State Corporations | K MART CORPORATION | 28 Liberty St., New York, New York 10005 |
| Oklahoma Business Registrations | K MART CORPORATION | 3333 Beverly Rd, Hoffman Estates, IL 60179 |
| Washington State Corporations | K MART CORPORATION | 3333 Beverly Rd, Hoffman Estates, IL 60179-0001 |
| Street Address |
4670 S 900 E |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84117-4802 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790037489 | Steven Weber | Pharmacist | 4670 S 900 E, Salt Lake City, UT 84117-4802 | 2012-10-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063052256 | Abundant Dental Care, P.C. | Dentist | 1548 E 4500 S #104, Holladay, UT 84117 | 2020-01-15 |
| 1578127221 | Signature Utah Dental Partners PC | Clinic/Center | 2240 E Murray Holladay Rd, Holladay, UT 84117 | 2019-04-29 |
| 1700392974 | Marette Monson, LLC | Community/Behavioral Health | 2180 East 4500 South, Suite 105, Holladay City, UT 84117 | 2017-12-23 |
| 1942714639 | Harmon City Inc | Pharmacy | 4675 South Holladay Blvd, Holladay, UT 84117 | 2017-11-17 |
| 1881119444 | Brianna Stewart | Physical Medicine & Rehabilitation | 5151 South 900 East, Suite 100, Salt Lake City, UT 84117 | 2017-08-04 |
| 1861842874 | Whitney Aste | Dentist | 1548 E 4500 S Ste 104, Salt Lake City, UT 84117 | 2016-06-21 |
| 1922403765 | Tri-peak, Pllc | Psychologist | 4535 S 2300 E, Suite B, Salt Lake City, UT 84117 | 2014-10-22 |
| 1356689566 | Mckenzie Vierig | Marriage & Family Therapist | 4568 S Highland Dr Ste 380, Millcreek, UT 84117 | 2013-01-22 |
| 1821348640 | Fabiola Marquez Jamieson | Social Worker | 4500 S 2180 E, Suite 165, Holladay, UT 84117 | 2012-09-19 |
| 1073882882 | Amy Rose White | Social Worker | 4500 South 2180 East, Suite 165, Holladay, UT 84117 | 2011-12-22 |
| Find all providers in zip 84117 | ||||
| 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 |
|---|---|---|---|---|
| 1518577741 | Black Panda LLC | Pharmacy | 2507 S State St, Salt Lake City, UT 84115-3109 | 2020-08-03 |
| 1447760228 | Meds In Motion, LLC | Pharmacy | 1200 E 3900 S Ste 1h, Salt Lake City, UT 84124-1300 | 2017-10-05 |
| 1164945192 | Walgreen Co | Pharmacy | 220 S 7th E, Salt Lake City, UT 84102-2106 | 2017-07-21 |
| 1417400797 | Hrx Pharmacy LLC | Pharmacy | 4227 S Highland Dr, Suite 6, Salt Lake City, UT 84124-2645 | 2016-08-03 |
| 1790157261 | Global Medical Therapeutics Inc | Pharmacy | 1890 S 3850 W Ste 121-a, Salt Lake City, UT 84104 | 2015-10-23 |
| 1457783201 | Pharmacare, LLC | Pharmacy | 729 N Redwood Rd, Attn Super Value Pharmacy, Salt Lake City, UT 84116-1909 | 2013-08-04 |
| 1568703650 | Amphex Pharmacy, LLC | Pharmacy | 898 E 3300 S, Salt Lake City, UT 84106-1508 | 2013-03-14 |
| 1043543754 | Associated Fresh Markets Inc | Pharmacy | 1638 S 9th E, Salt Lake City, UT 84105-2366 | 2009-09-13 |
| 1326371584 | Maceys Inc | Pharmacy | 4530 S Highland Dr, Salt Lake City, UT 84117-4202 | 2009-09-04 |
| 1275705493 | Walgreen Co | Pharmacy | 4690 S Holladay Blvd, Salt Lake City, UT 84117-5243 | 2008-03-27 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84117 |
Please comment or provide details below to improve the information on K MART CORP.
| 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.