K MART CORP (NPI# 1669403705) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669403705 |
| Entity Type | Organization |
| Organization Name | K MART CORP |
| Other Organization Name | KMART PHARMACY7154 |
| Practice Address |
620 Bankhead Hwy Carrollton GA 30117-1916 |
| Mailing Address |
3333 Beverly Rd Ac 367 B Hoffman Estates IL 60179-0001 |
| Practice Telephone | 7708321186 |
| Practice Fax Number | 7708345274 |
| 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 |
PHRE005271 | GA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000172433A | 05 | |
| PK | 2014014 | 01 | |
| GA | 00172433A | 05 |
| Other Name | Type Code |
|---|---|
| KMART PHARMACY7154 | 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 |
620 BANKHEAD HWY |
| City | CARROLLTON |
| State | GA |
| Zip Code | 30117-1916 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366789380 | Marjorie Ford Stowe | Pharmacist | 620 Bankhead Hwy, Carrollton, GA 30117-1916 | 2013-01-10 |
| 1750762597 | Christopher Ryan Dobry | Pharmacist | 620 Bankhead Hwy, Carrollton, GA 30117-1916 | 2015-06-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679199392 | Southern Rad Onc LLC | Radiology | 809 South Park Street, Carrollton, GA 30117 | 2020-06-18 |
| 1093361404 | Eyedeal Eyecare LLC | Optometrist | 1735 S Us 27, Carrollton, GA 30117 | 2019-08-12 |
| 1710412473 | Janis James | Optometrist | 1735 S, Us-27, Walmart Vision Center, Carrollton, GA 30117 | 2017-05-01 |
| 1568881951 | Omar Hajmurad | Anesthesiology | 812 S Park St Ste 5, Carrollton, GA 30117 | 2014-04-14 |
| 1134550353 | Goodbodys Minor Med Express Care | Nurse Practitioner | 1670 South Park St., Carrollton, GA 30117 | 2013-12-13 |
| 1306187570 | Myriam C Vela-ortiz | Internal Medicine | 157 Clinic Ave Ste 203, Carrollton, GA 30117 | 2013-03-12 |
| 1891030201 | Air Evac Ems, Inc. | Ambulance | 827 Old Bremen Rd, Carrollton, GA 30117 | 2012-12-11 |
| 1952682486 | Angelic Wings Transport, Inc. | Non-emergency Medical Transport (VAN) | 362 B Columbia Drive, Carrollton, GA 30117 | 2011-08-29 |
| 1073819256 | Atlanta Prosthetics & Orthotics, Inc. | Durable Medical Equipment & Medical Supplies | 812 South Park Street, Suite 2, Carrollton, GA 30117 | 2011-02-04 |
| 1255640348 | Amy Gilbert | Counselor | 515 Tanner St, Carrollton, GA 30117 | 2010-10-06 |
| Find all providers in zip 30117 | ||||
| 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 |
|---|---|---|---|---|
| 1316565880 | Ams Health Inc | Pharmacy | 4541 N Josey Ln Ste 250, Carrollton, TX 75010-4781 | 2020-07-10 |
| 1386203933 | Neo Texas LLC | Pharmacy | 1933 E Frankford Rd Ste 120, Carrollton, TX 75007-5394 | 2019-06-07 |
| 1548745219 | Locus Health, LLC | Pharmacy | 1205 N Josey Ln Ste B, Carrollton, TX 75006-6145 | 2018-09-28 |
| 1457848004 | Hillcrest Pharmacy, LLC | Pharmacy | 3065 N Josey Ln Ste 60, Carrollton, TX 75007-5348 | 2018-04-19 |
| 1043742737 | Sas Pharmacy Inc. | Pharmacy | 1205 N Josey Ln Ste 200a, Carrollton, TX 75006-6145 | 2017-03-31 |
| 1295140572 | B-pharm, Inc | Pharmacy | 1003 Highway 65 North, Suite B, Carrollton, MO 64633 | 2014-06-25 |
| 1639590995 | Agateno Technologies LLC | Pharmacy | 3648 Old Denton Rd Ste 104, Carrollton, TX 75007-7977 | 2014-01-03 |
| 1407129968 | Baylor Health Enterprises Lp | Pharmacy | 4323 N Josey Ln Ste 102, Carrollton, TX 75010-4630 | 2012-02-14 |
| 1215012570 | Texas Hematology/oncology Center, Pa | Pharmacy | 4352 North Josey Lane, Carrollton, TX 75010 | 2006-10-26 |
| 1083718860 | Cvs Pharmacy Inc | Pharmacy | 3065 N Josey Ln, Suite 64, Carrollton, TX 75007-5340 | 2006-09-12 |
| Find all providers in CARROLLTON | ||||
| City | CARROLLTON |
| Zip Code | 30117 |
Please comment or provide details below to improve the information on K MART CORP.
| 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.