K MART CORP (NPI# 1427089481) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427089481 |
| Entity Type | Organization |
| Organization Name | K MART CORP |
| Other Organization Name | KMART PHARMACY3441 |
| Practice Address |
3616 W Kimberly Rd Davenport IA 52806-3001 |
| Mailing Address |
3333 Beverly Rd Ac 367 B Hoffman Estates IL 60179-0001 |
| Practice Telephone | 5633863742 |
| Practice Fax Number | 5633919541 |
| 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 |
309 | IA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IA | 0147728 | 05 | |
| NCPDP PROVIDER IDENTIFICATION NUMBER | 1610066 | 01 |
| Other Name | Type Code |
|---|---|
| KMART PHARMACY3441 | 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 |
| Street Address |
3616 W KIMBERLY RD |
| City | DAVENPORT |
| State | IA |
| Zip Code | 52806-3001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790082576 | Natalie J Ramos | Pharmacist | 3616 W Kimberly Rd, Davenport, IA 52806-3001 | 2011-02-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912543257 | June Swain | Nurse Practitioner | Quad City Family Physician, 3940 Marquette Street, Davenport, IA 52806 | 2019-11-21 |
| 1881055747 | Jace Carter | Chiropractor | 235 West 35th Street Suite 2d, Davenport, IA 52806 | 2016-03-18 |
| 1538468210 | Cody Krech | Dentist | 141 E 46th St, Davenport, IA 52806 | 2011-03-21 |
| 1619287216 | Robert Earl Clark | Occupational Therapist | 6623 N Main St, Davenport, IA 52806 | 2010-10-15 |
| 1689902579 | Nicholas P. Carlson | Nurse Practitioner | 3801 Marguette Street, Suite 200, Davenport, IA 52806 | 2009-12-03 |
| 1295821114 | David Lee Botsko | Dentist | 2334 W. Kimberly Road, Davenport, IA 52806 | 2006-10-05 |
| 1598712903 | Select Specialty Hospital - Quad Cities Inc | Long Term Care Hospital | 1111 West Kimberly Road, Davenport, IA 52806 | 2006-05-30 |
| 1528030350 | Warren Wright | Occupational Therapist | 1008 W 35th St, Davenport, IA 52806 | 2006-02-06 |
| 1144291568 | Gerald Wallace Hess | Chiropractor | 2711 W 63rd St, Ste #1, Davenport, IA 52806 | 2006-02-01 |
| 1487642286 | Virginia Armstrong | Chiropractor | 4811 N Brady St Ste 1a, Davenport, IA 52806 | 2005-10-06 |
| Find all providers in zip 52806 | ||||
| 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 |
|---|---|---|---|---|
| 1003387697 | Creekside Pharmacy LLC | Pharmacy | 639 Morgan Street, Davenport, WA 99122 | 2018-12-08 |
| 1104127349 | Walgreen Co | Pharmacy | 40079 Highway 27, Davenport, FL 33837-7800 | 2010-11-04 |
| 1477730406 | Holiday Cvs LLC | Pharmacy | 5000 Grandview Pkwy, Davenport, FL 33837-2300 | 2008-01-22 |
| 1033207469 | Family Drug Center | Pharmacy | State Route 80, Davenport, VA 24239-0129 | 2006-10-11 |
| 1912002791 | Davenport Pharmacy Inc | Pharmacy | 525 Morgan St, Davenport, WA 99122 | 2006-09-14 |
| 1538174842 | Walgreen Co | Pharmacy | 1720 W Kimberly Rd, Davenport, IA 52806-4742 | 2006-07-29 |
| 1194769562 | Iowa Cvs Pharmacy LLC | Pharmacy | 1655 W Kimberly Rd, Davenport, IA 52806-5532 | 2006-06-16 |
| 1881172146 | Costco Wholesale Corporation | Pharmacy | 2790 East 53rd St., Davenport, IA 52807 | 2018-07-30 |
| 1295042133 | Jya, LLC | Pharmacy | 141 Webb Dr, Suite 100, Davenport, FL 33837-3951 | 2010-09-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013546308 | Hy Vee Inc | Pharmacy | 911 S K Ave, Vinton, IA 52349-1073 | 2020-04-07 |
| 1164050944 | Corridor Pharmacy | Pharmacy | 650 W Cherry St Ste 7, North Liberty, IA 52317-9025 | 2020-03-29 |
| 1932740024 | St Luke's Jones Regional Medical Center | Pharmacy | 1795 Highway 64 E Ste 2, Anamosa, IA 52205-2112 | 2019-10-01 |
| 1316407018 | Harlan Pharmacy, LLC | Pharmacy | 1024 5th St, Harlan, IA 51537-1427 | 2019-03-20 |
| 1306304027 | State University of Iowa | Pharmacy | 1360 N Dodge St Ste 1100, Iowa City, IA 52245-6104 | 2019-03-12 |
| 1265999387 | Bancroft Apothecary Lp | Pharmacy | 106 W Ramsey St, Bancroft, IA 50517-8078 | 2019-02-25 |
| 1023588159 | Mark Oleson | Pharmacy | 1100 Broad Street, Adair, IA 50002 | 2018-12-02 |
| 1598235723 | Cjk Pharmacy, LLC | Pharmacy | 3100 E Ave Nw Ste 102, Cedar Rapids, IA 52405-2962 | 2018-11-30 |
| 1144701582 | Madsen Inc | Pharmacy | 307 2nd. St., Gladbrook, IA 50635-5063 | 2018-08-23 |
| 1376024869 | Hy Vee Inc | Pharmacy | 3285 Crosspark Road, Coralville, IA 52241 | 2018-08-23 |
| 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.