KMART OF MICHIGAN INC (NPI# 1497786487) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497786487 |
| Entity Type | Organization |
| Organization Name | KMART OF MICHIGAN INC |
| Other Organization Name | KMART PHARMACY3308 |
| Practice Address |
1025 S Lapeer Rd Lake Orion MI 48360-1429 |
| Mailing Address |
3333 Beverly Rd Ac 367 B Hoffman Estates IL 60179-0001 |
| Practice Telephone | 2486936259 |
| Practice Fax Number | 2486938651 |
| 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 |
5301004930 | MI | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2042015 | 01 | |
| MI | 2533213 | 05 |
| Other Name | Type Code |
|---|---|
| KMART PHARMACY3308 | 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 |
| 1457382434 | Kmart of Michigan Inc | Pharmacy | 215 N Maple Rd, Ann Arbor, MI 48103-2823 | 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 |
| Street Address |
1025 S LAPEER RD |
| City | LAKE ORION |
| State | MI |
| Zip Code | 48360-1429 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124409446 | Kyle Vires | Licensed Practical Nurse | 2271 Geyer Ct, Lake Orion, MI 48360 | 2015-06-11 |
| 1871931592 | Ihsan Asbahi | Anesthesiology | 1234 S Lapeer Rd, Lake Orion, MI 48360 | 2013-06-05 |
| 1205119567 | Michigan Bone and Joint Center | Orthopaedic Surgery | 1251 S. Lapeer Rd., Suite #102, Lake Orion, MI 48360 | 2011-09-23 |
| 1629226139 | Travis L Summerville | Physical Therapist | 1298 Walloon Way, Lake Orion, MI 48360 | 2008-09-09 |
| 1982878609 | Audrey Vizzaccaro | Physician Assistant | 1261 South Lapeer Rd, Ste 201, Lake Orion, MI 48360 | 2008-04-14 |
| 1881872265 | H & L Drugs Inc | Durable Medical Equipment & Medical Supplies | 1455 S Lapeer, Suite 101, Lake Orion, MI 48360 | 2008-02-07 |
| 1598952129 | Oakland Psychological Clinic, P.C. | Counselor | 1455 S Lapeer Rd Ste 175n, Lake Orion, MI 48360 | 2007-09-27 |
| 1700098704 | Laura Elizabeth Salome | Audiologist | 1176 S. Lapeer Rd, Lake Orion, MI 48360 | 2007-05-04 |
| 1780743658 | Frank James Iulianelli | Chiropractor | 2523 South Lapeer Road, Lake Orion, MI 48360 | 2006-12-07 |
| 1942377122 | James C Komendera Dds PC | Dentist | 1135 S Lapeer Rd, Lake Orion, MI 48360 | 2006-11-30 |
| Find all providers in zip 48360 | ||||
| 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 |
|---|---|---|---|---|
| 1881292001 | Healthwatch Pharmacy Inc | Pharmacy | 1375 S Lapeer Rd Ste 102, Lake Orion, MI 48360-1421 | 2020-10-09 |
| 1669713053 | Aoeg LLC | Pharmacy | 1412 S Lapeer Rd, Lake Orion, MI 48360-1437 | 2013-03-08 |
| 1851403703 | Woodward Detroit Cvs, L.L.C. | Pharmacy | 295 S Broadway St, Lake Orion, MI 48362-2738 | 2006-08-31 |
| 1710095187 | H & L Drugs Inc. | Pharmacy | 1455 S. Lapeer Rd. Ste 101, Lake Orion, MI 48360 | 2006-08-27 |
| 1477576916 | Walgreen Co | Pharmacy | 3520 S Baldwin Rd, Lake Orion, MI 48359-1500 | 2006-07-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609477389 | Rose Rex LLC | Pharmacy | 2330 S Milford Rd Ste 114, Highland, MI 48357-4982 | 2020-11-08 |
| 1508466194 | Grand Gratiot Pharmacy, LLC | Pharmacy | 7011 Gratiot Ave Ste 100, Detroit, MI 48207-1973 | 2020-10-31 |
| 1104424530 | Advance Care Rx, LLC | Pharmacy | 500 N Cass St, Berrien Springs, MI 49103-1069 | 2020-10-16 |
| 1023616554 | Henry Ford Health System | Pharmacy | 2800 W Grand Blvd, Detroit, MI 48208 | 2020-10-16 |
| 1225645781 | Good Choice Pharmacy LLC | Pharmacy | 6750 E 10 Mile Rd, Center Line, MI 48015-1166 | 2020-09-29 |
| 1487269122 | Canfield Pharmacy LLC | Pharmacy | 4673 Conner St, Detroit, MI 48215-2028 | 2020-09-10 |
| 1851905707 | Skidway Pharmacy LLC | Pharmacy | 1830 Greenwood Rd, Prescott, MI 48756-8627 | 2020-09-08 |
| 1023621190 | Azam Mohsen Mesleh | Pharmacy | 6811 Theisen St, Dearborn, MI 48126-1927 | 2020-08-28 |
| 1821606310 | S&k Pharmacy Inc. | Pharmacy | 1916 Davison Rd, Flint, MI 48506-4423 | 2020-07-21 |
| 1891313755 | Highland Park Oak Street Pharmacy, LLC | Pharmacy | 14529 Woodward Ave, Highland Park, MI 48203-2905 | 2020-07-08 |
| Find all providers with the same taxonomy | ||||
| City | LAKE ORION |
| Zip Code | 48360 |
Please comment or provide details below to improve the information on KMART OF MICHIGAN INC.
| 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.