K MART CORP (NPI# 1447281589) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447281589 |
| Entity Type | Organization |
| Organization Name | K MART CORP |
| Other Organization Name | KMART PHARMACY7017 |
| Practice Address |
1705 S Main St Roswell NM 88203-1873 |
| Mailing Address |
3333 Beverly Rd Ac 367 B Hoffman Estates IL 60179-0001 |
| Practice Telephone | 5756239001 |
| Practice Fax Number | 5756250428 |
| 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 |
PH00001176 | NM | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | 000063081 | 05 | |
| PK | 2057172 | 01 |
| Other Name | Type Code |
|---|---|
| KMART PHARMACY7017 | 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 |
1705 S MAIN ST |
| City | ROSWELL |
| State | NM |
| Zip Code | 88203-1873 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023593662 | Brandon Jacobi | Pharmacist | 1705 S Main St, Roswell, NM 88203-1873 | 2018-09-29 |
| 1073922779 | Tyler Cowart | Pharmacist | 1705 S Main St, Roswell, NM 88203-1873 | 2014-08-06 |
| 1598010449 | David Ellis Martin | Pharmacist | 1705 S Main St, Roswell, NM 88203-1873 | 2012-07-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770115586 | Katherine Bolin | Behavior Technician | 333 West Brasher Rd. #200, Roswell, NM 88203 | 2020-02-10 |
| 1437660040 | Pecos Valley Eye Surgery Center, LLC | Clinic/Center | 1610 Se Main Street, Roswell, NM 88203 | 2017-10-23 |
| 1285031286 | Wheelchair and Walker Rentals, Inc. | Durable Medical Equipment & Medical Supplies | 305 W Mcgaffey St, Roswell, NM 88203 | 2014-11-20 |
| 1447585914 | Whole World Health Care, PC | Pediatrics | 109 W. Bland, Roswell, NM 88203 | 2009-10-16 |
| 1780825372 | Complete Rehab Adult Services | Clinic/Center | 109 W Bland, Roswell, NM 88203 | 2009-03-12 |
| 1710127220 | Roswell Medical Care | Health Maintenance Organization | 111 W Hobbs, Roswell, NM 88203 | 2009-02-23 |
| 1336330513 | Savitri Aguiar | Internal Medicine | 1511 South Grand, Roswell, NM 88203 | 2007-08-05 |
| 1750455523 | Francisco Casio Bicol Jr. | Occupational Therapist | 200 W 1st St Ste 527, Roswell, NM 88203 | 2006-11-20 |
| 1699861542 | Susan Lee Voigt | Counselor | 200 W 1st, Ste 532, Roswell, NM 88203 | 2006-10-05 |
| 1245336940 | Founders Healthcare LLC | Durable Medical Equipment & Medical Supplies | 104 N Missouri Ave, Roswell, NM 88203 | 2006-09-16 |
| Find all providers in zip 88203 | ||||
| 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 |
|---|---|---|---|---|
| 1356835821 | Roswellrx Pharmacy LLC | Pharmacy | 11105 Crabapple Rd, Roswell, GA 30075-2403 | 2018-06-19 |
| 1750410536 | United Supermarkets LLC | Pharmacy | 900 W 2nd St, Roswell, NM 88201-3006 | 2007-03-05 |
| 1982708806 | Georgia Cvs Pharmacy, L.L.C. | Pharmacy | 12070 Crabapple Rd, Roswell, GA 30075-2422 | 2006-09-12 |
| 1215031158 | Georgia Cvs Pharmacy, L.L.C. | Pharmacy | 895 Holcomb Bridge Rd, Roswell, GA 30076-1954 | 2006-09-12 |
| 1801801709 | Walgreen Co | Pharmacy | 1835 N Main St, Roswell, NM 88201-5168 | 2006-07-29 |
| 1114932316 | Walgreen Co | Pharmacy | 695 W Crossville Rd, Roswell, GA 30075-2500 | 2006-07-29 |
| 1598386351 | Katherine Mackenzie Wood Wimbley | Pharmacy | 791 Atlanta St, Roswell, GA 30075-4452 | 2020-05-04 |
| 1861975088 | Cvs Pharmacy Inc | Pharmacy | 700 N Union Ave, Roswell, NM 88201-3956 | 2018-09-13 |
| 1528558186 | Masoud Khorsand- Sahbaie Md P A | Pharmacy | 400 Military Heights Pl, Roswell, NM 88201-6407 | 2018-05-18 |
| 1558802207 | Miles Connect LLC | Pharmacy | 1570 Holcomb Bridge Rd, Suite 200, Roswell, GA 30076-4703 | 2017-03-14 |
| Find all providers in ROSWELL | ||||
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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.