K MART CORP (NPI# 1669403788) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669403788 |
| Entity Type | Organization |
| Organization Name | K MART CORP |
| Other Organization Name | KMART PHARMACY4997 |
| Practice Address |
550 First Colonial Rd Virginia Beach VA 23451-6186 |
| Mailing Address |
3333 Beverly Rd Ac 367 B Hoffman Estates IL 60179-0001 |
| Practice Telephone | 7574255958 |
| Practice Fax Number | 7574372909 |
| 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 |
0201001489 | VA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | 008526702 | 05 | |
| VA | 8526702 | 05 | |
| PK | 2103156 | 01 |
| Other Name | Type Code |
|---|---|
| KMART PHARMACY4997 | 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 |
550 FIRST COLONIAL RD |
| City | VIRGINIA BEACH |
| State | VA |
| Zip Code | 23451-6186 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245553510 | Scott Alan Mahrenholz | Pharmacist | 550 First Colonial Rd, Virginia Beach, VA 23451-6186 | 2010-03-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316547268 | Brynn Arica Carey | Speech-Language Pathologist | Laskin Road Annex, 1413 Laskin Road, Virginia Beach, VA 23451 | 2020-10-29 |
| 1851864094 | Erica Genevieve Johns | Counselor | 253 C Street, Camp Pendleton, Virginia Beach, VA 23451 | 2019-01-10 |
| 1407327729 | Crystal Michelle Larios | Physical Therapy Assistant | Westminster Canterbury, Virginia Beach, VA 23451 | 2018-12-14 |
| 1215423322 | Ketan Patel | Dentist | 395 Norfolk Ave, Virginia Beach, VA 23451 | 2018-07-02 |
| 1356844427 | Kristina Maria Matthews | Nurse's Aide | 1206 Laskin Road, Suite 140-g, Virginia Beach, VA 23451 | 2018-03-14 |
| 1437652823 | Beach Medical Suppliers LLC | Durable Medical Equipment & Medical Supplies | 2256 W. Great Neck Rd, Virginia Beach, VA 23451 | 2018-03-13 |
| 1740782291 | Sherree Weeks | Speech-Language Pathologist | 1413 Laskin Rd., Va. Beach, VA 23451 | 2018-03-01 |
| 1649709007 | Christine Herslow | Registered Nurse | 2200 Elder Road, Virginia Beach, VA 23451 | 2017-06-08 |
| 1538611066 | Wal-mart Stores East, Lp | Technician/Technologist | 546 First Colonial Road, Virginia Beach, VA 23451 | 2016-11-01 |
| 1306182795 | John Leroy Stacy Jr. | Counselor | 409 Birdneck Cir, Virginia Beach, VA 23451 | 2012-12-12 |
| Find all providers in zip 23451 | ||||
| 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 |
|---|---|---|---|---|
| 1952962581 | Ag Pharmacy, LLC | Pharmacy | 3322 Holland Rd Ste A, Virginia Beach, VA 23452-4826 | 2019-06-25 |
| 1598153785 | Harris Teeter LLC | Pharmacy | 2105 Princess Anne Road, Suite 100, Virginia Beach, VA 23456 | 2014-12-23 |
| 1851714026 | Harris Teeter,llc | Pharmacy | 4540 Princess Anne Road, Virginia Beach, VA 23462 | 2014-01-24 |
| 1427365691 | North Beach Enterprises, Inc. | Pharmacy | 3198 Pacific Ave, Suite 124, Virginia Beach, VA 23451-2949 | 2010-09-08 |
| 1619154341 | Harris Teeter LLC | Pharmacy | 5060 Ferrell Parkway, Virginia Beach, VA 23464 | 2008-01-24 |
| 1043355423 | Excelscript Inc | Pharmacy | 3053 Shore Dr, Virginia Beach, VA 23451-1247 | 2007-02-21 |
| 1922193051 | Harris Teeter, LLC | Pharmacy | 2476 Nimmo Parkway, Virginia Beach, VA 23456 | 2006-10-04 |
| 1134212434 | Harris Teeter, LLC | Pharmacy | 2800 Artic Avenue, Virginia Beach, VA 23451 | 2006-10-02 |
| 1588768816 | Harris Teeter, LLC | Pharmacy | 3333 Virginia Bch Blvd. #101, Virginia Beach, VA 23452 | 2006-09-08 |
| 1700894649 | Creative Pharmacy Solutions East LLC | Pharmacy | 4001 Virginia Beach Blvd Ste 110, Virginia Beach, VA 23452-1759 | 2006-08-04 |
| Find all providers in VIRGINIA BEACH | ||||
| City | VIRGINIA BEACH |
| Zip Code | 23451 |
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.