K MART CORP (NPI# 1437180403) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437180403 |
| Entity Type | Organization |
| Organization Name | K MART CORP |
| Other Organization Name | KMART PHARMACY 3912 |
| Practice Address |
1072 Mountain Laurel Plz Latrobe PA 15650-5214 |
| Mailing Address |
3333 Beverly Rd Ac 367 B Hoffman Estates IL 60179-0001 |
| Practice Telephone | 7245379412 |
| Practice Fax Number | 7245379522 |
| Mailing Telephone | 8472864089 |
| Mailing Fax Number | 8472861603 |
| 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 |
PP414457L | PA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2080775 | 01 | |
| PA | 1007503260208 | 05 | |
| PA | 1007662280070 | 05 |
| Other Name | Type Code |
|---|---|
| KMART PHARMACY 3912 | 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 |
1072 MOUNTAIN LAUREL PLZ |
| City | LATROBE |
| State | PA |
| Zip Code | 15650-5214 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396067120 | Donna Van Dyke | Pharmacist | 1072 Mountain Laurel Plz, Latrobe, PA 15650-5214 | 2010-02-21 |
| 1205299682 | Marc Christopher Cassella Jr. | Pharmacist | 1072 Mountain Laurel Plz, Latrobe, PA 15650-5214 | 2016-04-01 |
| 1003138371 | Sharon Ann Perry | Pharmacist | 1072 Mountain Laurel Plz, Latrobe, PA 15650-5214 | 2010-02-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841849429 | Diane Louise Gabler | Technician | 936 Unity Street, Latrobe, PA 15650 | 2019-09-06 |
| 1518529379 | Living Essential Coaching, LLC | Health Educator | 128 Innovative Lane, Latrobe, PA 15650 | 2019-07-02 |
| 1568931756 | Camille Velazquez | Psychologist | 5954 Pa-981, Latrobe, PA 15650 | 2018-11-16 |
| 1942713409 | Excela Health Physician Practices, Inc | Family Medicine | 100 Excela Health Drive, Latrobe, PA 15650 | 2017-11-07 |
| 1881048692 | Brittney Saxinger | Pharmacist | 200 Mountain Laurel Plz, Latrobe, PA 15650 | 2016-04-18 |
| 1316193832 | Michelle Sue Culler | Nurse Practitioner | 555 Rt. 217, Latrobe, PA 15650 | 2008-08-15 |
| 1558529420 | Dennis Blasiele | Dentist | 1015 Ligonier St, Latrobe, PA 15650 | 2008-05-28 |
| 1508053893 | Assisted Living Concepts Inc | Assisted Living Facility | 2021 James Street, Latrobe, PA 15650 | 2007-10-01 |
| 1144436734 | Mary Elizabeth Griffin | Psychologist | 2906 Ligonier St. Ext--911 Address, Latrobe, PA 15650 | 2007-05-14 |
| 1023230836 | Anna Marie Pianko | Physical Therapist | 535 Mcfarland Road, Latrobe, PA 15650 | 2007-05-02 |
| Find all providers in zip 15650 | ||||
| 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 |
|---|---|---|---|---|
| 1669602355 | Walgreen Co | Pharmacy | 2801 Sharkys Dr, Latrobe, PA 15650-4231 | 2009-07-16 |
| 1972518892 | Giant Eagle Inc | Pharmacy | 1050 Mt Laurel Pl, Rt 30, Latrobe, PA 15650 | 2006-07-29 |
| 1104822402 | Schropp Pharmacy Inc | Pharmacy | 709 Ligonier St, Latrobe, PA 15650-1825 | 2005-06-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376143990 | Valerie Hellriegel | Pharmacy | 567 N Route 100, Bechtelsville, PA 19505-9263 | 2020-11-01 |
| 1134729791 | John P Russo | Pharmacy | 608 E Hillcrest Ave, New Castle, PA 16105-2254 | 2020-10-31 |
| 1538769864 | Luzerne Discount Pharmacy Inc | Pharmacy | 101 Main St Unit D, Luzerne, PA 18709-1209 | 2020-10-27 |
| 1417555616 | Dubois Regional Medical Center | Pharmacy | 265 Holiday Inn Drive Route 68, Clarion, PA 16214 | 2020-10-12 |
| 1780290197 | Weis Markets, Inc. | Pharmacy | 112 Atlantic Ave., Dingmans Ferry, PA 18328 | 2020-09-21 |
| 1275146177 | Newport Pharmacy LLC | Pharmacy | 57 S 2nd St, Newport, PA 17074-1402 | 2020-08-28 |
| 1699387779 | Allegheny Valley Hospital Retail Pharmacy | Pharmacy | 1301 Carlisle St Fl 3, Natrona Heights, PA 15065-1152 | 2020-08-19 |
| 1396355426 | Mdk Health | Pharmacy | 3985 Columbia Ave Unit 2, Columbia, PA 17512-9003 | 2020-08-04 |
| 1861000861 | Koso,llc | Pharmacy | 407 Shadeland Ave, Drexel Hill, PA 19026-1437 | 2020-07-16 |
| 1184241408 | Roosevelt Pharmacy LLC | Pharmacy | 2600 Cottman Ave, Philadelphia, PA 19149-1301 | 2020-07-02 |
| 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.