K MART CORP (NPI# 1477584506) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477584506 |
| Entity Type | Organization |
| Organization Name | K MART CORP |
| Other Organization Name | KMART PHARMACY4723 |
| Practice Address |
1650 Airport Blvd Pensacola FL 32504-8618 |
| Mailing Address |
3333 Beverly Rd Ac 367 B Hoffman Estates IL 60179-0001 |
| Practice Telephone | 8504844555 |
| Practice Fax Number | 8504763337 |
| Mailing Telephone | 8472864089 |
| Mailing Fax Number | 8472861603 |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2011-05-23 |
| Authorized Official Name | MICHAEL HAMILTON (DIRECTOR MANAGED CARE SERVICES) |
| Authorized Official Telephone | 8472867735 |
| 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 |
PH0011635 | FL | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NCPDP PROVIDER IDENTIFICATION NUMBER | 1066706 | 01 | |
| FL | 101183900 | 05 |
| Other Name | Type Code |
|---|---|
| KMART PHARMACY4723 | 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 |
1650 AIRPORT BLVD |
| City | PENSACOLA |
| State | FL |
| Zip Code | 32504-8618 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801929104 | Leigh Ann Dominey | Pharmacist | 1650 Airport Blvd, Pensacola, FL 32504-8618 | 2007-03-14 |
| 1710209374 | Scott Georges | Pharmacist | 1650 Airport Blvd, Pensacola, FL 32504-8618 | 2010-02-24 |
| 1598920779 | Karen S Miles | Pharmacist | 1650 Airport Blvd, Pensacola, FL 32504-8618 | 2008-07-27 |
| 1467584813 | Sears Holdings Corporation | Pharmacy | 1650 Airport Blvd, Pensacola, FL 32504-8618 | 2007-03-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659978393 | Quinyatta Stride | Behavior Technician | 2511 Creighton Rd., Pensacola, FL 32504 | 2020-10-06 |
| 1962017657 | Pt Solutions of Pensacola LLC | Occupational Therapist | 2114 Creighton Rd, Ste C, Pensacola, FL 32504 | 2020-09-10 |
| 1982226742 | Elevate Behavioral Solutions | Behavioral Analyst | 4045 Renoir St, Pensacola, FL 32504 | 2020-05-14 |
| 1760021349 | Veteran Evaluations of Florida | Internal Medicine | 2411 Executive Plaza Drive, Suite A, Pensacola, FL 32504 | 2019-12-31 |
| 1215575527 | First City Health LLC | Pharmacy | 6005 College Parkway, Suite 1, Pensacola, FL 32504 | 2019-12-17 |
| 1184261158 | Claire Ann Letendre | Audiologist | 5153 N 9th Ave Pediatric Off Building, Pensacola, FL 32504 | 2019-12-09 |
| 1083275101 | Benjamin Mcmillon | Chiropractor | 2629 Creighton Road, Suite 1, Pensacola, FL 32504 | 2019-06-28 |
| 1407342595 | Faryal Munir | Student in an Organized Health Care Education/Training Program | Uf Pediatric Residency 5151 North 9th Ave, 6th Floor Nemours, Pensacola, FL 32504 | 2018-07-02 |
| 1497252050 | Sibyl Tenille Page | Nurse Practitioner | 5147 N 9th Ave Ste 322, Pensacola, FL 32504 | 2018-04-10 |
| 1396272589 | Sacred Heart Hospital | General Acute Care Hospital | 2552 Carmel Heights Rd, Pensacola, FL 32504 | 2017-05-18 |
| Find all providers in zip 32504 | ||||
| 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 |
|---|---|---|---|---|
| 1215575527 | First City Health LLC | Pharmacy | 6005 College Parkway, Suite 1, Pensacola, FL 32504 | 2019-12-17 |
| 1639680242 | Gastroenterology Associates of Pensacola Pa | Pharmacy | 4531 N Davis Hwy Ste B, Pensacola, FL 32503-2770 | 2017-10-23 |
| 1922300565 | Josephs Pharmacy LLC | Pharmacy | 3130 N Pace Blvd, Pensacola, FL 32505-5140 | 2010-12-02 |
| 1043536964 | American Pharmacy Solutions LLC | Pharmacy | 5001 Commerce Park Cir, Pensacola, FL 32505-1659 | 2010-04-16 |
| 1497890800 | Walgreen Co | Pharmacy | 85 Beverly Pkwy, Pensacola, FL 32505-2813 | 2007-02-21 |
| 1932275690 | East Hill Pharmacy Inc | Pharmacy | 2899 N 12th Ave, Pensacola, FL 32503-4001 | 2006-11-27 |
| 1154495505 | A & E Pharmacy, Inc. | Pharmacy | 923 N New Warrington Rd, Pensacola, FL 32506-4250 | 2006-11-19 |
| 1952408445 | Holiday Cvs LLC | Pharmacy | 8100 N Davis Hwy, Pensacola, FL 32514-6093 | 2006-09-19 |
| 1033216528 | Holiday Cvs LLC | Pharmacy | 4500 Saufley Field Rd, Pensacola, FL 32526 | 2006-09-19 |
| 1649374513 | Holiday Cvs LLC | Pharmacy | 3880 N 9th Ave, Pensacola, FL 32503-2802 | 2006-09-12 |
| Find all providers in PENSACOLA | ||||
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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.