KMART OF MICHIGAN INC (NPI# 1396776381) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396776381 |
| Entity Type | Organization |
| Organization Name | KMART OF MICHIGAN INC |
| Other Organization Name | KMART PHARMACY3191 |
| Practice Address |
2905 Union Lake Rd Commerce Township MI 48382-3565 |
| Mailing Address |
3333 Beverly Rd Ac 367 B Hoffman Estates IL 60179-0001 |
| Practice Telephone | 2483600402 |
| Practice Fax Number | 2483636829 |
| Mailing Telephone | 8472864089 |
| Mailing Fax Number | 8472861603 |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2009-06-18 |
| Authorized Official Name | ROBBERT AYSHFORD (DIVISIONAL VICE PRESIDENT) |
| 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 |
5301004940 | MI | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 2536716 | 05 | |
| NCPDP PROVIDER IDENTIFICATION NUMBER | 2328905 | 01 |
| Other Name | Type Code |
|---|---|
| KMART PHARMACY3191 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114353919 | Kmart of Michigan Inc | Pharmacy | 2425 S I 75 Business Loop, Grayling, MI 49738-2042 | 2013-09-25 |
| 1609984095 | Kmart of Michigan Inc | Pharmacy | 1151 S Otsego Ave # A, Gaylord, MI 49735-1789 | 2006-08-27 |
| 1760413751 | Kmart of Michigan Inc | Pharmacy | 2500 E M21, Corunna, MI 48817 | 2006-07-06 |
| 1700817780 | Kmart of Michigan Inc | Pharmacy | 19800 West Rd, Woodhaven, MI 48183-3319 | 2006-07-06 |
| 1609807692 | Kmart of Michigan Inc | Pharmacy | 6730 River Rd, Marine City, MI 48039-2284 | 2006-07-06 |
| 1538190517 | Kmart of Michigan Inc | Pharmacy | 100 E Maple Rd, Troy, MI 48083-2714 | 2006-07-06 |
| 1457382434 | Kmart of Michigan Inc | Pharmacy | 215 N Maple Rd, Ann Arbor, MI 48103-2823 | 2006-07-06 |
| 1538190525 | Kmart of Michigan Inc | Pharmacy | 710 Chicago Dr, Holland, MI 49423-3074 | 2006-07-06 |
| 1750312740 | Kmart of Michigan Inc | Pharmacy | 17580 Frazho Rd, Roseville, MI 48066-3829 | 2006-07-06 |
| 1336170323 | Kmart of Michigan Inc | Pharmacy | 2948 S State Rd, Ionia, MI 48846-9475 | 2006-07-06 |
| Street Address |
2905 UNION LAKE RD |
| City | COMMERCE TOWNSHIP |
| State | MI |
| Zip Code | 48382-3565 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861824583 | Kroger Co of Michigan | Durable Medical Equipment & Medical Supplies | 2905 Union Lake Rd, Commerce Township, MI 48382-3565 | 2013-08-05 |
| 1871139055 | Sandra Habib | Specialist/Technologist | 2905 Union Lake Rd, Commerce Township, MI 48382-3565 | 2019-11-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700373933 | Kevin Piper | Occupational Therapist | 3517 Clark Circle, Commerce, MI 48382 | 2018-04-13 |
| 1215483953 | Jodi Lynn Van Proeyen | Community Health Worker | 8749 Buckskin Drive, Commerce Township, MI 48382 | 2016-09-01 |
| 1912382532 | Lindsay Anne Brossy | Nurse Practitioner | 8906 Commerce Rd Unit 5, Commerce Twp, MI 48382 | 2015-07-24 |
| 1386991008 | Joao Najar | Dentist | 1440 Woodview Lane, Commerce, MI 48382 | 2012-08-13 |
| 1275828709 | Stacy Ann Madany | Physician Assistant | 9640 Commerce Road, Suite 100, Commerce, MI 48382 | 2011-06-13 |
| 1801038740 | Kent C. Bowden Do Pllc | Surgery | 1 William Carls Drive, Huron Valley Sinai Hospital, Commerce, MI 48382 | 2009-03-24 |
| 1982895207 | Stephanie Lee Adams | Specialist/Technologist | 8391 E. Commerce Rd., Suite 108, Commerce Township, MI 48382 | 2007-08-05 |
| 1780890459 | William Lee Thompson | Dentist | 2900 Union Lake Rd Ste 105, Commerce Township, MI 48382 | 2007-05-16 |
| 1184836082 | Kadima Jewish Support Services for Adults With Mental Illness | Community/Behavioral Health | 15999 West 12 Mile Road, Southfield, MI 48382 | 2007-05-04 |
| 1821132945 | Alan Elliot Parven | Optometrist | 3000 Commerce Crossing Rd, Commerce Township, MI 48382 | 2007-02-20 |
| Find all providers in zip 48382 | ||||
| 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 |
|---|---|---|---|---|
| 1023587532 | Familicare Pharmacy | Pharmacy | 46670 W Pontiac Trl Ste 5, Commerce Township, MI 48390-4041 | 2018-11-14 |
| 1912437351 | Commerce Family Pharmacy, LLC | Pharmacy | 2549 Union Lake Rd, Commerce Township, MI 48382-3555 | 2017-06-18 |
| 1962504258 | Woodward Detroit Cvs, L.L.C. | Pharmacy | 1325 E Commerce Rd, Commerce Township, MI 48382-1240 | 2006-09-05 |
| 1104936723 | Costco Wholesale Corporation | Pharmacy | 3000 Commerce Xing, Commerce Township, MI 48390 | 2006-08-30 |
| 1912200320 | Vhs Huron Valley-sinai Hospital Inc | Pharmacy | 1 William Carls Dr, Commerce Township, MI 48382-2201 | 2010-12-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609477389 | Rose Rex LLC | Pharmacy | 2330 S Milford Rd Ste 114, Highland, MI 48357-4982 | 2020-11-08 |
| 1508466194 | Grand Gratiot Pharmacy, LLC | Pharmacy | 7011 Gratiot Ave Ste 100, Detroit, MI 48207-1973 | 2020-10-31 |
| 1104424530 | Advance Care Rx, LLC | Pharmacy | 500 N Cass St, Berrien Springs, MI 49103-1069 | 2020-10-16 |
| 1023616554 | Henry Ford Health System | Pharmacy | 2800 W Grand Blvd, Detroit, MI 48208 | 2020-10-16 |
| 1881292001 | Healthwatch Pharmacy Inc | Pharmacy | 1375 S Lapeer Rd Ste 102, Lake Orion, MI 48360-1421 | 2020-10-09 |
| 1225645781 | Good Choice Pharmacy LLC | Pharmacy | 6750 E 10 Mile Rd, Center Line, MI 48015-1166 | 2020-09-29 |
| 1487269122 | Canfield Pharmacy LLC | Pharmacy | 4673 Conner St, Detroit, MI 48215-2028 | 2020-09-10 |
| 1851905707 | Skidway Pharmacy LLC | Pharmacy | 1830 Greenwood Rd, Prescott, MI 48756-8627 | 2020-09-08 |
| 1023621190 | Azam Mohsen Mesleh | Pharmacy | 6811 Theisen St, Dearborn, MI 48126-1927 | 2020-08-28 |
| 1821606310 | S&k Pharmacy Inc. | Pharmacy | 1916 Davison Rd, Flint, MI 48506-4423 | 2020-07-21 |
| Find all providers with the same taxonomy | ||||
| City | COMMERCE TOWNSHIP |
| Zip Code | 48382 |
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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.