K MART CORP (NPI# 1598796591) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598796591 |
| Entity Type | Organization |
| Organization Name | K MART CORP |
| Other Organization Name | KMART PHARMACY9633 |
| Practice Address |
301 Henslee Dr Dickson TN 37055-2050 |
| Mailing Address |
3333 Beverly Rd Ac 367 B Hoffman Estates IL 60179-0001 |
| Practice Telephone | 6154467485 |
| Practice Fax Number | 6157409728 |
| 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 |
0000000330 | TN | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 4417487 | 05 | |
| PK | 2088841 | 01 |
| Other Name | Type Code |
|---|---|
| KMART PHARMACY9633 | 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 |
301 HENSLEE DR |
| City | DICKSON |
| State | TN |
| Zip Code | 37055-2050 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457684706 | Lewis Currie Moore Jr. | Pharmacist | 301 Henslee Dr, Dickson, TN 37055-2050 | 2009-09-17 |
| 1245574417 | Donald Patrick Orgain | Pharmacist | 301 Henslee Dr, Dickson, TN 37055-2050 | 2012-11-12 |
| 1073835369 | William Russell Pevahouse | Pharmacist | 301 Henslee Dr, Dickson, TN 37055-2050 | 2010-02-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801406186 | Raven Julia Jackson | Dentist | 445 Tn-46 S, Dickson, TN 37055 | 2020-08-03 |
| 1336767839 | Logan Newman | Student in an Organized Health Care Education/Training Program | 102 Us70 East, Suite 2, Dickson, TN 37055 | 2020-07-10 |
| 1720575012 | Vb Tennessee I Pllc | Dentist | 2027 Thornton Dr, Dickson, TX 37055 | 2018-04-23 |
| 1376075358 | Sharon Elizabeth Sharber | Nurse Practitioner | 111 Highway 70 E Ste E, Dickson, TN 37055 | 2017-03-29 |
| 1992255921 | Karen Alonzo | Occupational Therapy Assistant | 312 N Charlotte St, Dickson, TN 37055 | 2016-10-13 |
| 1356727408 | Aurora Pharmacy Inc | Pharmacy | 318 East College Street, Suite 102, Dickson, TN 37055 | 2015-07-30 |
| 1295121820 | Jeffrey Nicholas Williams | Pharmacy Technician | 120 Brazzell Rd, Dickson, TN 37055 | 2015-04-10 |
| 1760894398 | Joshua A. Vaughn | Physical Therapist | 766 Highway 46 South, Dickson, TN 37055 | 2014-06-02 |
| 1902217292 | Keith Payton | Dentist | 217 Highway 46 Ste D, Dickson, TN 37055 | 2014-05-08 |
| 1073953840 | John Harrison | Dentist | 134 Us-70, Dickson Pediatric Dentistry, Dickson, TN 37055 | 2013-06-26 |
| Find all providers in zip 37055 | ||||
| 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 |
|---|---|---|---|---|
| 1356727408 | Aurora Pharmacy Inc | Pharmacy | 318 East College Street, Suite 102, Dickson, TN 37055 | 2015-07-30 |
| 1316040017 | Tennessee Cvs Pharmacy, L.L.C. | Pharmacy | 122 Highway 70 E, Dickson, TN 37055-2034 | 2006-09-07 |
| 1124188032 | Dmrx LLC | Pharmacy | 758 Highway 46 S, Suite A, Dickson, TN 37055-2556 | 2006-12-11 |
| 1629186044 | Community Pharmacy Care Inc | Pharmacy | 127 Crestview Park Dr, Ste 100, Dickson, TN 37055-2854 | 2006-08-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033718317 | Rockvegas Enterprises Inc Dba Gateway Pharmacy | Pharmacy | 524 N Gateway Ave, Rockwood, TN 37854-2353 | 2020-10-19 |
| 1124626767 | Knoxville Rx Corp | Pharmacy | 10205 Kingston Pike Ste E, Knoxville, TN 37922-3285 | 2020-10-15 |
| 1073126181 | Off Center, LLC | Pharmacy | 910 Overton Plz, Livingston, TN 38570-1753 | 2020-08-28 |
| 1316557937 | Guardian Pharmacy of Tennessee Three, LLC | Pharmacy | 661 E Lane St Ste B, Shelbyville, TN 37160-3437 | 2020-08-07 |
| 1447860507 | Fph LLC | Pharmacy | 2200 N Central Ave, Humbolt, TN 38343 | 2020-08-04 |
| 1366069965 | Plaza Pharmacy LLC | Pharmacy | 3024 Covington Pike Ste 5, Memphis, TN 38128-5043 | 2020-06-30 |
| 1548886104 | Tumlin Rx, LLC | Pharmacy | 104 E Main Blvd, Church Hill, TN 37642-3724 | 2020-06-19 |
| 1366065278 | Life Well Pharmacy, LLC | Pharmacy | 2408 Susannah St Ste 3, Johnson City, TN 37601-1765 | 2020-05-27 |
| 1699398602 | Walgreen Co | Pharmacy | 262 Danny Thomas Pl Ste 100rx, Memphis, TN 38105-3678 | 2020-05-26 |
| 1053931881 | Jones & Joslin, Pllc | Pharmacy | 4249 Highway 411 Ste 5, Madisonville, TN 37354-1544 | 2020-04-22 |
| 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.