K MART CORP (NPI# 1316978455) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316978455 |
| Entity Type | Organization |
| Organization Name | K MART CORP |
| Other Organization Name | KMART PHARMACY4376 |
| Practice Address |
120 E Sunset Dr Waukesha WI 53189-2109 |
| Mailing Address |
3333 Beverly Rd Ac 367 B Hoffman Estates IL 60179-0001 |
| Practice Telephone | 2625478331 |
| Practice Fax Number | 2625471390 |
| Mailing Telephone | 8472864089 |
| Mailing Fax Number | 8472861603 |
| 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 |
7096 | WI | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 33016100 | 05 | |
| NCPDP PROVIDER IDENTIFICATION NUMBER | 5113965 | 01 |
| Other Name | Type Code |
|---|---|
| KMART PHARMACY4376 | 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 |
120 E SUNSET DR |
| City | WAUKESHA |
| State | WI |
| Zip Code | 53189-2109 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972818268 | Claudia Ann Schreiner | Pharmacist | 120 E Sunset Dr, Waukesha, WI 53189-2109 | 2010-08-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275017907 | Shopko Stores Operating Co LLC | Eyewear Supplier (Equipment, not the service) | 1166 W Sunset Drive, Suite F100, Waukesha, WI 53189 | 2018-09-19 |
| 1851841910 | Jane Knoblock | Speech-Language Pathologist | S48w23663 Merlin Ln, Waukesha, WI 53189 | 2016-10-12 |
| 1063850246 | Tracey Sue Kochanski | Nurse Practitioner | 1130 W Sunset Ave, Waukesha, WI 53189 | 2013-06-10 |
| 1376981811 | Mark Russell Schmitt | Registered Nurse | 1804 Dixie Dr., Waukesha, WI 53189 | 2013-06-06 |
| 1760738546 | Schreve and Associates Inc. | Durable Medical Equipment & Medical Supplies | 406 Travis Ln., Ste 50, Waukesha, WI 53189 | 2012-07-30 |
| 1407152879 | Kimberly Lyn Moravec | Registered Nurse | W326 S3994 Spring Ridge Ct, Waukesha, WI 53189 | 2011-02-02 |
| 1154505113 | Le Ann Le Blanc | Day Training, Developmentally Disabled Services | S31 W28251 Sunset Drive, Waukesha, WI 53189 | 2007-12-26 |
| 1801934807 | Wisconsin Vision, Inc. | Technician/Technologist | 203a Sunset Drive, Waukesha, WI 53189 | 2007-02-02 |
| 1497828172 | Donna G. Kraklow D.d.s. | Dentist | 1507 E Sunset Dr, Suite 110, Waukesha, WI 53189 | 2006-11-17 |
| 1285713461 | Robert Evan Davies | Dentist | 2117 Corporate Dr., Suite 100, Waukesha, WI 53189 | 2006-11-06 |
| Find all providers in zip 53189 | ||||
| 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 |
|---|---|---|---|---|
| 1386982957 | Waukesha Health System Inc | Pharmacy | N16w24131 Riverwood Dr Ste 1121, Waukesha, WI 53188-1106 | 2013-01-16 |
| 1114152683 | Roundys Supermarkets Inc | Pharmacy | 1220 W Sunset Dr, Waukesha, WI 53189-8423 | 2009-05-27 |
| 1265580526 | Roundys Supermarkets Inc | Pharmacy | 220 E Sunset Dr, Waukesha, WI 53189-7602 | 2007-01-05 |
| 1619071628 | Moreland Plaza Pharmacy, Inc | Pharmacy | 827 W Moreland Blvd, Waukesha, WI 53188-2963 | 2006-09-11 |
| 1891702775 | Walgreen Co | Pharmacy | 230 Madison St, Waukesha, WI 53188-5148 | 2006-08-02 |
| 1417964305 | Walgreen Co | Pharmacy | 2700 N Grandview Blvd, Waukesha, WI 53188-1611 | 2006-08-02 |
| 1538174602 | Walgreen Co | Pharmacy | 601 Meadowbrook Rd, Waukesha, WI 53188-7312 | 2006-07-29 |
| 1285656983 | Wisconsin Cvs Pharmacy LLC | Pharmacy | 2401 Kossow Rd, Waukesha, WI 53186-2904 | 2006-07-24 |
| 1053345272 | Aurora Pharmacy Inc | Pharmacy | 304 Delafield St, Suite 100, Waukesha, WI 53188-3641 | 2006-07-11 |
| 1134525694 | Genoa Healthcare, LLC | Pharmacy | 514 Riverview Ave, Room 238, Waukesha, WI 53188-3631 | 2014-11-11 |
| Find all providers in WAUKESHA | ||||
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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.