K MART CORP (NPI# 1326079468) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326079468 |
| Entity Type | Organization |
| Organization Name | K MART CORP |
| Other Organization Name | KMART PHARMACY4254 |
| Practice Address |
900 N Koeller St Oshkosh WI 54902-3244 |
| Mailing Address |
3333 Beverly Rd Ac 367 B Hoffman Estates IL 60179-0001 |
| Practice Telephone | 9202338100 |
| Practice Fax Number | 9202330126 |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2008-10-10 |
| Authorized Official Name | ROBBERT AYSHFORD (DIRECTOR OF PHARMACY ADMINISTRATION) |
| Authorized Official Telephone | 8472868242 |
| 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 |
5980 | WI | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 33008400 | 05 | |
| NCPDP PROVIDER IDENTIFICATION NUMBER | 5113408 | 01 |
| Other Name | Type Code |
|---|---|
| KMART PHARMACY4254 | 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 |
900 N KOELLER ST |
| City | OSHKOSH |
| State | WI |
| Zip Code | 54902-3244 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528688363 | Grandpa Ray's Home Care Partners LLC | In Home Supportive Care | 1755 W 7th Avenue, Oshkosh, WI 54902 | 2020-04-22 |
| 1942866314 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1212 S Koeller St, Oshkosh, WI 54902 | 2019-05-11 |
| 1508299926 | Wisconsin Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 1736 W. 9th Ave., Oshkosh, WI 54902 | 2013-08-21 |
| 1881971513 | Eric D Jachthuber | Pharmacist | 950 Koeller Rd, Oshkosh, WI 54902 | 2011-11-09 |
| 1912158148 | Jennifer L Daly | Registered Nurse | 648 West 5th Avenue, Oshkosh, WI 54902 | 2008-10-07 |
| 1093873028 | Phyllis Ann Pieplow | Registered Nurse | 2307 Doty St, Oshkosh, WI 54902 | 2006-12-04 |
| 1336210939 | Juliette P M Sterkens | Audiologist | 1820 West Pointe Drive, Fox Valley Hearing Ctr Inc, Oshkosh, WI 54902 | 2006-11-13 |
| 1043266927 | Christopher S. Mcfarlane | Dentist | 1875 West Pointe Dr., Oshkosh, WI 54902 | 2006-05-25 |
| 1285688192 | Theresa Lynn Petrick Gatchell | Optometrist | 1300 S Koeller Road, Oshkosh, WI 54902 | 2006-05-22 |
| 1558329821 | Teresa M Vanaacken | Physical Therapist | 300 S Koeller Street, Suite B, Oshkosh, WI 54902 | 2006-05-03 |
| Find all providers in zip 54902 | ||||
| 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 |
|---|---|---|---|---|
| 1558607283 | Sawyer Street Hometown Pharmacy LLC | Pharmacy | 321 N Sawyer St, Oshkosh, WI 54902-4252 | 2012-12-28 |
| 1013939610 | Wisconsin Cvs Pharmacy LLC | Pharmacy | 1900 S Koeller St, Oshkosh, WI 54902-6153 | 2006-07-24 |
| 1093749210 | Aurora Pharmacy Inc | Pharmacy | 414 Doctors Ct, Suite 100, Oshkosh, WI 54901-2065 | 2006-07-11 |
| 1346274560 | Aurora Pharmacy Inc | Pharmacy | 1940 S Koeller St, Oshkosh, WI 54902-6200 | 2006-07-11 |
| 1528064540 | Ame | Pharmacy | 311 Main St, Oshkosh, NE 69154-6112 | 2005-06-23 |
| 1942537014 | Roundys Supermarkets Inc | Pharmacy | 1940 S Koeller St, Oshkosh, WI 54902-6200 | 2009-11-11 |
| 1407880628 | Aurora Pharmacy Inc | Pharmacy | 855 N Westhaven Dr, Oshkosh, WI 54904-7668 | 2006-07-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942816939 | The Duluth Clinic, Ltd. | Pharmacy | 204 Belknap St, Ste 100, Superior, WI 54880-2964 | 2020-09-16 |
| 1902417207 | Ipack Pharmacy LLC | Pharmacy | 17000 W North Ave Ste 108w, Brookfield, WI 53005-4423 | 2020-08-11 |
| 1851939037 | Ascension Wisconsin Pharmacy, Inc | Pharmacy | 10180 Washington Ave Ste 102, Mount Pleasant, WI 53177-1604 | 2019-12-18 |
| 1558906354 | Life Change Rx 4 LLC | Pharmacy | 6300 N 76th St Ste 246, Milwaukee, WI 53218-1208 | 2019-11-15 |
| 1285278978 | Life Change Rx 3 LLC | Pharmacy | 7115 W Capitol Dr, Milwaukee, WI 53216-2051 | 2019-11-05 |
| 1295377703 | Hayat Pharmacy 21 LLC. | Pharmacy | 2333 Northwestern Ave Ste 120, Racine, WI 53404-2520 | 2019-10-16 |
| 1487296737 | Xperience Pharmacy LLC | Pharmacy | 5715 W Appleton Ave, Milwaukee, WI 53210-2250 | 2019-10-08 |
| 1962053421 | Hayat Pharmacy 19 LLC | Pharmacy | 805 W. Layton Ave. Suite A, Milwaukee, WI 53221 | 2019-09-26 |
| 1275182925 | Walgreen Co | Pharmacy | 2265 N Mayfair Rd, Wauwatosa, WI 53226-2207 | 2019-09-05 |
| 1982257200 | Hayat Pharmacy 16 LLC | Pharmacy | 603 N 36th St, Milwaukee, WI 53208-3826 | 2019-07-17 |
| 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.