K MART CORP (NPI# 1588695647) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588695647 |
| Entity Type | Organization |
| Organization Name | K MART CORP |
| Other Organization Name | KMART PHARMACY7416 |
| Practice Address |
17550 Halsted St Homewood IL 60430-2006 |
| Mailing Address |
3333 Beverly Rd Ac 367 B Hoffman Estates IL 60179-0001 |
| Practice Telephone | 7089221588 |
| Practice Fax Number | 7089220116 |
| Mailing Telephone | 8472862527 |
| Mailing Fax Number | 8472861603 |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2013-08-08 |
| Authorized Official Name | ELIZABETH ZANDER (DIRECTOR MANAGED CARE) |
| Authorized Official Telephone | 8472867661 |
| 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 |
054-011555 | IL | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2022278 | 01 |
| Other Name | Type Code |
|---|---|
| KMART PHARMACY7416 | 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 |
17550 HALSTED ST |
| City | HOMEWOOD |
| State | IL |
| Zip Code | 60430-2006 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841217148 | Walmart Inc. | Durable Medical Equipment & Medical Supplies | 17550 Halsted St, Homewood, IL 60430-2006 | 2006-07-16 |
| 1497356588 | Danielle Magas | Pharmacist | 17550 Halsted St, Homewood, IL 60430-2001 | 2020-11-04 |
| 1932709508 | Christianah Aluko | Pharmacist | 17550 Halsted St, Homewood, IL 60430-2001 | 2020-10-31 |
| 1790119535 | Lana Faraj | Pharmacist | 17550 Halsted St, Homewood, IL 60430-2006 | 2013-08-28 |
| 1336471556 | Allan M Goga | Pharmacist | 17550 Halsted St, Homewood, IL 60430-2006 | 2010-02-12 |
| 1407188014 | Ronald Anthony Demaria | Pharmacist | 17550 Halsted St, Homewood, IL 60430-2006 | 2010-02-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831702307 | Sms Dental LLC | Dentist | 17727 Halsted St, Homewood, IL 60430 | 2020-08-25 |
| 1619431020 | Jewish Child and Family Services | Clinic/Center | 1800 Ridge Road, Unit 204, Suite 4, Homewood, IL 60430 | 2019-01-30 |
| 1437636966 | Miracle Healthcare LLC | Clinic/Center | 2024 Hickory Rd Ste 306, Homewood, IL 60430 | 2018-07-26 |
| 1518443381 | Elizabeth Carol Rodgers | Developmental Therapist | 2820 Willow Rd, Homewood, IL 60430 | 2018-07-16 |
| 1114431764 | Kyla Shaneek O'neal | Counselor | 935 175th St Ste 300, Homewood, IL 60430 | 2017-11-17 |
| 1699221986 | Visionworks Inc | Eyewear Supplier (Equipment, not the service) | 17723 S Halsted St, Homewood, IL 60430 | 2016-08-28 |
| 1528420155 | Nathan Patrick Lagacy | Counselor | 3650 W. 183rd St., Homewood, IL 60430 | 2016-03-23 |
| 1891175725 | Quaneta Gates | Homeopath | 18216 Harwood Ave Unit 1 S, Homewood, IL 60430 | 2015-06-05 |
| 1164817334 | Shachi Pandya | Family Medicine | 18350 Kedzie Ave Ste 101, Homewood, IL 60430 | 2015-04-03 |
| 1790182327 | Floss Dental Care LLC | Preferred Provider Organization | 18650 Dixie Highway, Homewood, IL 60430 | 2014-11-25 |
| Find all providers in zip 60430 | ||||
| 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 |
|---|---|---|---|---|
| 1609114271 | Alabama Cvs Pharmacy LLC | Pharmacy | 531 Brookwood Vlg, Homewood, AL 35209-4501 | 2013-01-16 |
| 1114002136 | Walter Lagestee Incorporated | Pharmacy | 2345 183rd St, Homewood, IL 60430-3140 | 2006-10-26 |
| 1124033428 | Walgreen Co | Pharmacy | 820 183rd St, Homewood, IL 60430-3505 | 2006-07-29 |
| 1184639221 | Walgreen Co | Pharmacy | 18300 Governors Hwy, Homewood, IL 60430-2910 | 2006-07-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215538582 | Wilmington Pharmacy LLC | Pharmacy | 600 W Baltimore St, Wilmington, IL 60481-1281 | 2020-11-03 |
| 1952909632 | Cordant Pharmacy Illinois, LLC | Pharmacy | 8623 W Bryn Mawr Ave Ste 504, Chicago, IL 60631-3525 | 2020-10-14 |
| 1386242352 | Letitride, Inc. | Pharmacy | 501 W Oak Street, Fairbury, IL 61739 | 2020-10-13 |
| 1699389890 | J2sb LLC | Pharmacy | 398 W Army Trail Rd Ste 120, Bloomingdale, IL 60108-2398 | 2020-09-04 |
| 1891308045 | Apotheco Pharmacy Lincoln Park LLC | Pharmacy | 2140 N Halsted St, Chicago, IL 60614-4385 | 2020-08-27 |
| 1982217345 | Costco Wholesale Corporation | Pharmacy | 2002 N. Neil St., Champaign, IL 61820 | 2020-08-26 |
| 1710599485 | Costco Wholesale Corporation | Pharmacy | 16261 S Boulevard Pl, Plainfield, IL 60586-4400 | 2020-08-23 |
| 1982212635 | Grand Pharmacy LLC | Pharmacy | 229 W Grand Ave Ste F, Bensenville, IL 60106-3365 | 2020-07-20 |
| 1871110254 | Illini Clinic Pharmacy Inc | Pharmacy | 103 N Prospect St, Cambridge, IL 61238-1148 | 2020-07-01 |
| 1831716745 | The Project of The Quad Cities | Pharmacy | 1701 River Dr Ste 106, Moline, IL 61265-1384 | 2020-06-26 |
| 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.