KMART OF MICHIGAN INC (NPI# 1457382434) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457382434 |
| Entity Type | Organization |
| Organization Name | KMART OF MICHIGAN INC |
| Other Organization Name | KMART PHARMACY4105 |
| Practice Address |
215 N Maple Rd Ann Arbor MI 48103-2823 |
| Mailing Address |
3333 Beverly Rd Ac 367 B Hoffman Estates IL 60179-0001 |
| Practice Telephone | 7347690758 |
| Practice Fax Number | 7347611468 |
| Mailing Telephone | 8472864089 |
| Mailing Fax Number | 8472861603 |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2014-10-30 |
| Authorized Official Name | DAIN RUSK (VP/GM PHARMACY) |
| Authorized Official Telephone | 8472863348 |
| 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 |
5301004896 | MI | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2040664 | 01 | |
| MI | 2528652 | 05 |
| Other Name | Type Code |
|---|---|
| KMART PHARMACY4105 | 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 |
| 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 |
| 1447282298 | Kmart of Michigan Inc | Pharmacy | 4002 S Dort Hwy, Flint, MI 48507-2138 | 2006-07-06 |
| Street Address |
215 N MAPLE RD |
| City | ANN ARBOR |
| State | MI |
| Zip Code | 48103-2823 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043839343 | Melissa Sylvia Danan Rilko | Social Worker | 1775 Timber Trail, Ann Arbor, MI 48103 | 2020-04-16 |
| 1427602929 | Ashwini Gulwadi, Pllc | Psychiatry & Neurology | 2100 S Main Street, Suite A, Unit 4, Ann Arbor, MI 48103 | 2019-08-01 |
| 1225593155 | Brent Aaron Reeve | Chiropractor | 203 S. Zeeb Rd., Suite 106, Ann Arbor, MI 48103 | 2019-02-05 |
| 1548746779 | Loren Camano Shkolnik | Registered Nurse | 3200 W Liberty Rd Ste C5, Ann Arbor, MI 48103 | 2018-07-11 |
| 1982193256 | Jacob B Nienhuis | Psychologist | 4488 Jackson Rd Ste 7b, Ann Arbor, MI 48103 | 2018-05-02 |
| 1053818633 | Regents of The University of Michigan | Eyewear Supplier (Equipment, not the service) | 380 Parkland Plz Ste 210, Ann Arbor, MI 48103 | 2018-04-10 |
| 1376052647 | Shivika Verma | Dentist | 3071 Signature Blvd, Apartment #f, Ann Arbor, MI 48103 | 2017-09-29 |
| 1881118206 | Harrison Udensi Igwe | Clinic/Center | 522 South Maple Stree, Ann Arbor, MI 48103 | 2017-07-27 |
| 1841727641 | Kathleen Murphy | Psychologist | 4141 Woodland Drive, Ann Arbor, MI 48103 | 2017-05-11 |
| 1972037133 | Jonathan Broek | Dietitian, Registered | 2920 Lakeview Dr, Ann Arbor, MI 48103 | 2017-04-14 |
| Find all providers in zip 48103 | ||||
| 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 |
|---|---|---|---|---|
| 1003301045 | Ann Arbor Pharmacy LLC | Pharmacy | 2418 E Stadium Blvd, Ann Arbor, MI 48104 | 2018-06-22 |
| 1497014757 | Costco Wholesale Corporation | Pharmacy | 771 Airport Blvd, Ann Arbor, MI 48108 | 2012-05-08 |
| 1093002115 | Dix Boro Pharmacy PC | Pharmacy | 5770 Plymouth Rd, Ann Arbor, MI 48105-9312 | 2011-07-10 |
| 1275740219 | Salaman & Worthing Enterprises LLC | Pharmacy | 3280 Washtenaw Ave, Ste B, Ann Arbor, MI 48104-4250 | 2007-05-17 |
| 1861594103 | Woodward Detroit Cvs, L.L.C. | Pharmacy | 2228 S Main St, Ann Arbor, MI 48103-6935 | 2006-09-05 |
| 1417059700 | Woodward Detroit Cvs, L.L.C. | Pharmacy | 1700 S Industrial and Simpson, Ann Arbor, MI 48104 | 2006-09-05 |
| 1043322969 | Woodward Detroit Cvs, L.L.C. | Pharmacy | 3535 Plymouth Rd, Ann Arbor, MI 48105-2602 | 2006-08-31 |
| 1093827933 | Woodward Detroit Cvs, L.L.C. | Pharmacy | 2100 W Stadium Blvd, Ann Arbor, MI 48103-4544 | 2006-08-31 |
| 1538277900 | Village Apothecary Inc | Pharmacy | 1112 S University Ave, Ann Arbor, MI 48104-2522 | 2006-08-27 |
| 1639284664 | Kundrat Prescriptions LLC | Pharmacy | 2355 E Stadium Blvd, Ann Arbor, MI 48104-4800 | 2006-08-20 |
| Find all providers in ANN ARBOR | ||||
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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.