KMART STORES OF TEXAS LLC (NPI# 1265464010) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265464010 |
| Entity Type | Organization |
| Organization Name | KMART STORES OF TEXAS LLC |
| Other Organization Name | KMART PHARMACY4201 |
| Practice Address |
1120 Mcrae Blvd El Paso TX 79925-7642 |
| Mailing Address |
3333 Beverly Rd Ac 367 B Hoffman Estates IL 60179-0001 |
| Practice Telephone | 9155931296 |
| Practice Fax Number | 9155904589 |
| Mailing Telephone | 8472864089 |
| Mailing Fax Number | 8477471553 |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2015-02-04 |
| 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 |
23046 | TX | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2101346 | 01 | |
| TX | 464445 | 05 |
| Other Name | Type Code |
|---|---|
| KMART PHARMACY4201 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265463269 | Kmart Stores of Texas LLC | Pharmacy | 1405 E Expressway 83, Mission, TX 78572-6612 | 2006-07-06 |
| 1932453941 | Kmart Stores of Texas LLC | Durable Medical Equipment & Medical Supplies | 3333 Beverly Rd, Bc 259 Aa, Hoffman Estates, IL 60179-0001 | 2012-10-30 |
| 1083645089 | Kmart Stores of Texas LLC | Pharmacy | 5001 San Dario Ave, Laredo, TX 78041-5777 | 2006-07-06 |
| 1174554174 | Kmart Stores of Texas LLC | Pharmacy | 210 Sw Georgia Ave, Sweetwater, TX 79556 | 2006-07-06 |
| 1356372353 | Kmart Stores of Texas LLC | Pharmacy | 3701 N 23rd St, Mcallen, TX 78501-6007 | 2006-07-06 |
| 1447281449 | Kmart Stores of Texas LLC | Pharmacy | 1101 S Fort Hood St, Killeen, TX 76541-7451 | 2006-07-06 |
| 1538190533 | Kmart Stores of Texas LLC | Pharmacy | 11330 Montwood Dr, El Paso, TX 79936-4383 | 2006-07-06 |
| 1710918719 | Kmart Stores of Texas LLC | Pharmacy | 1400 Wildcat Dr, Portland, TX 78374-2813 | 2006-07-06 |
| 1992736995 | Kmart Stores of Texas LLC | Pharmacy | 655 Sunland Park Dr, El Paso, TX 79912-5205 | 2006-07-06 |
| 1275564270 | Kmart Stores of Texas LLC | Pharmacy | 2440 Pablo Kisel Blvd, Brownsville, TX 78526-4095 | 2006-07-06 |
| Street Address |
1120 MCRAE BLVD |
| City | EL PASO |
| State | TX |
| Zip Code | 79925-7642 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689927261 | Jonathan Mohler | Pharmacist | 1120 Mcrae Blvd, El Paso, TX 79925-7642 | 2012-10-19 |
| 1104270495 | Tiera Proctor | Pharmacist | 1120 Mcrae Blvd, El Paso, TX 79925-7642 | 2016-04-22 |
| 1154758423 | Todd H. S. Kitamori | Pharmacist | 1120 Mcrae Blvd, El Paso, TX 79925-7642 | 2013-10-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003434820 | Francisco Andres Escobar | Dentist | 2200 N Yardbrough Dr, Suite N, El Paso, TX 79925 | 2020-07-08 |
| 1982259495 | Cruz Elvia Corral | Assisted Living Facility | 10165 Bermuda, El Paso, TX 79925 | 2019-08-02 |
| 1740846179 | Sister Sisters In Home Care Services LLC | In Home Supportive Care | 9327 Sims Drive, Suite F, El Paso, TX 79925 | 2019-05-10 |
| 1245790450 | Mario Salinas | Student in an Organized Health Care Education/Training Program | 10301 Gateway Blvd W, El Paso, Texas 79925, El Paso, TX 79925 | 2019-03-22 |
| 1720559289 | Sweet Care Home Care Providers LLC | PACE Provider Organization | 7917 Sunmount Dr, El Paso, TX 79925 | 2018-12-10 |
| 1083130215 | Javier Calzadilla Jr. | Behavior Technician | 9900 Montana Ave Ste C6, El Paso, TX 79925 | 2017-08-18 |
| 1942721980 | Isela Cristina Sanchez | Specialist/Technologist | 3021 Killarney St., El Paso, TX 79925 | 2017-06-29 |
| 1831629617 | Rebekah E Alvarez | Behavior Technician | 2200 North Yarabrough Suite B, Apt 103, El Paso, TX 79925 | 2017-06-14 |
| 1841646817 | Imelda Barbosa | Counselor | 9455 Viscount 170, El Paso, TX 79925 | 2016-05-10 |
| 1528426491 | Salnor, Inc. | Clinic/Center | 8517 Lockheed Dr., El Paso, TX 79925 | 2016-02-05 |
| Find all providers in zip 79925 | ||||
| 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 |
|---|---|---|---|---|
| 1942862164 | Larjems Investments LLC | Pharmacy | 1568 Joe Battle Blvd Ste 107, El Paso, TX 79936-8905 | 2019-07-09 |
| 1659932267 | Rio Grande Pharmacy, LLC | Pharmacy | 5500 Doniphan Dr. Ste 201-202, El Paso, TX 79932 | 2019-06-25 |
| 1326514233 | Amerkian,inc. | Pharmacy | 4501 Hercules Ave Ste B, El Paso, TX 79904-3310 | 2018-10-18 |
| 1023561487 | East El Paso Physicians' Medical Center, LLC | Pharmacy | 1400 George Dieter Dr Ste 190, El Paso, TX 79936-7656 | 2016-08-02 |
| 1770973406 | Pro Kima, LLC | Pharmacy | 1891 N Lee Trevino Dr Ste 200, El Paso, TX 79936-4132 | 2015-02-03 |
| 1003226093 | Wal-mart Stores Texas LLC | Pharmacy | 101 E Redd Rd, El Paso, TX 79932-1981 | 2014-04-30 |
| 1518213255 | Cvs Pharmacy Inc | Pharmacy | 1901 George Dieter Dr, El Paso, TX 79936-3855 | 2012-07-31 |
| 1861532368 | Tigua Pharmacy Inc | Pharmacy | 8269 N Loop Dr, El Paso, TX 79907-4234 | 2007-02-07 |
| 1194887349 | Alameda Thrifty Pharmacy Inc | Pharmacy | 4900 Alameda Ave, El Paso, TX 79905-2802 | 2006-12-14 |
| 1609952621 | Cvs Pharmacy Inc | Pharmacy | 745 N Zaragoza Rd, El Paso, TX 79907-4751 | 2006-10-31 |
| Find all providers in EL PASO | ||||
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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.