KMART CORPORATION (NPI# 1669403713) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669403713 |
| Entity Type | Organization |
| Organization Name | KMART CORPORATION |
| Other Organization Name | KMART PHARMACY3987 |
| Practice Address |
1075 Middle Country Rd Middle Island NY 11953-2514 |
| Practice Telephone | 6313450378 |
| Practice Fax Number | 6319243386 |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2007-07-08 |
| Authorized Official Name | DALE PURVIS (DIR THIRD PARTY ADMINISTRATION) |
| Authorized Official Telephone | 8472862942 |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 333600000X | Pharmacy | 021045 | NY | Suppliers |
| X | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OTHER ID NUMBER-COMMERCIAL NUMBER | 3398698 | 01 | |
| NY | 01288637 | 05 |
| Other Name | Type Code |
|---|---|
| KMART PHARMACY3987 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619299146 | Kmart Corporation | Pharmacy | 545 Concord Pkwy N, Concord, NC 28027-6738 | 2010-02-25 |
| 1215968276 | Kmart Corporation | Pharmacy | 190 Stadium Dr, Defiance, OH 43512-4602 | 2006-07-06 |
| 1952332066 | Kmart Corporation | Pharmacy | 2400 W 29th St, Greeley, CO 80631-8525 | 2006-07-06 |
| 1275564320 | Kmart Corporation | Pharmacy | 210 Saratoga Rd, Scotia, NY 12302-4509 | 2006-07-06 |
| 1700817707 | Kmart Corporation | Pharmacy | 2705 Parleys Way, Salt Lake City, UT 84109-1619 | 2006-07-06 |
| 1467483461 | Kmart Corporation | Pharmacy | 1547 Highway 59 S, Thief River Falls, MN 56701-3413 | 2006-07-06 |
| 1932130085 | Kmart Corporation | Pharmacy | 15 Park Ave Ste 22, Clifton Park, NY 12065-2924 | 2006-07-06 |
| 1083645048 | Kmart Corporation | Pharmacy | 2707 W Broadway St, Princeton, IN 47670-9420 | 2006-07-06 |
| 1306877428 | Kmart Corporation | Pharmacy | 175 N West State Rd, American Fork, UT 84003-1485 | 2006-07-06 |
| 1427089556 | Kmart Corporation | Pharmacy | 4855 Summit Ridge Dr, Reno, NV 89523-7936 | 2006-07-06 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Vermont Business Registrations | KMART CORPORATION | 3333 Beverly Rd., Hoffman Estates, IL 60179 |
| Oklahoma Business Registrations | KMART CORPORATION | 3100 W. Big Beaver Rd., Troy, MI 48084 |
| Indiana Business Entities | KMART CORPORATION | 3333 Beverly Road, B2-130b, Hoffman Estates, IL 60179 |
| Street Address |
1075 MIDDLE COUNTRY RD |
| City | MIDDLE ISLAND |
| State | NY |
| Zip Code | 11953-2514 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205461639 | Knickerbocker Dialysis Inc | Clinic/Center | 1277 Middle Country Rd, Middle Island, NY 11953 | 2020-03-05 |
| 1598252553 | Karen Simpson | Dietitian, Registered | 23 Summersweet Drive, Middle Island, NY 11953 | 2018-04-16 |
| 1699285502 | Amanda Rebekah Maye | Licensed Practical Nurse | 24 Wilson Avenue, Middle Island, NY 11953 | 2017-10-05 |
| 1982042065 | Shanti Kumari Chand | Licensed Practical Nurse | 49 Crest St, Oak Hollow Nursing Center, Middle Island, NY 11953 | 2013-06-11 |
| 1154664886 | Achieve Beyond Oediatric Therapy and Early Intervention Services | Early Intervention Provider Agency | 1103 Stonegate Way, Middle Island, NY 11953 | 2013-04-01 |
| 1831434018 | Amanda M Titus | Licensed Practical Nurse | 6 Redbud Ct, Middle Island, NY 11953 | 2012-11-29 |
| 1740561810 | Daniel Joseph Mckiernan | Registered Nurse | 217 Lake Point Cir, Middle Island, NY 11953 | 2011-09-02 |
| 1760787212 | Marissa Rodriguez | Speech-Language Pathologist | 41 Yaphank Middle Island Rd, Middle Island, NY 11953 | 2011-01-13 |
| 1376861542 | Sara Buckley | Licensed Practical Nurse | 341 Lake Pointe Dr, Middle Island, NY 11953 | 2010-05-12 |
| 1669645818 | Kimberley Jean Levy | Physician Assistant | 281 Middle Country Road, Middle Islana, NY 11953 | 2008-04-09 |
| Find all providers in zip 11953 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |
| 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: added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235267436 | King Kullen Pharmacies Corp | Pharmacy | 1235 Middle Country Rd, Middle Island, NY 11953-2515 | 2007-03-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437758141 | North Shore Chemists LLC | Pharmacy | 800 Northern Blvd Ste 4, Great Neck, NY 11021-5314 | 2020-10-22 |
| 1477152627 | Mary Imogene Bassett Hospital | Pharmacy | 231 N Genesee St Fl 2, Utica, NY 13502 | 2020-10-20 |
| 1023625548 | Otc Group LLC | Pharmacy | 2792 Ocean Ave Unit 5, Brooklyn, NY 11229-4730 | 2020-09-29 |
| 1932712817 | Guoyi Lin | Pharmacy | 13351 41st Rd First Floor, Flushing, NY 11355-5837 | 2020-08-28 |
| 1740891001 | Cureatr Inc | Pharmacy | 17 W 20th St Fl 3, New York, NY 10011-3702 | 2020-08-11 |
| 1609486562 | Phils Pill Pharmacy, Inc | Pharmacy | 8387 Woodhaven Blvd, Jamaica, NY 11421-1533 | 2020-08-05 |
| 1679182349 | Marvel Pharmacy Inc | Pharmacy | 9612 Liberty Ave, Ozone Park, NY 11417-1624 | 2020-07-28 |
| 1114545837 | Edgar Murcia | Pharmacy | 7702 Roosevelt Ave Ste C, Jackson Heights, NY 11372-6604 | 2020-07-09 |
| 1811513724 | Link Pharmacy | Pharmacy | 456 Avenue P, Brooklyn, NY 11223-2895 | 2020-06-17 |
| 1396361259 | Banani Road 11 LLC | Pharmacy | 181-04 Hillside Ave, Jamaica, NY 11432 | 2020-06-17 |
| Find all providers with the same taxonomy | ||||
| City | MIDDLE ISLAND |
| Zip Code | 11953 |
Please comment or provide details below to improve the information on KMART CORPORATION.
| 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.