K MART CORP (NPI# 1689605644) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689605644 |
| Entity Type | Organization |
| Organization Name | K MART CORP |
| Other Organization Name | KMART PHARMACY3784 |
| Practice Address |
1825 N State Route 19 Fremont OH 43420-1037 |
| Mailing Address |
3333 Beverly Rd Ac 367 B Hoffman Estates IL 60179-0001 |
| Practice Telephone | 4193343900 |
| Practice Fax Number | 4193343347 |
| 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 |
02-0747400 | OH | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 0934403 | 05 | |
| PK | 2073120 | 01 |
| Other Name | Type Code |
|---|---|
| KMART PHARMACY3784 | 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 |
1825 N STATE ROUTE 19 |
| City | FREMONT |
| State | OH |
| Zip Code | 43420-1037 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770805053 | Christy Anne Brudzinski | Pharmacist | 1825 N State Route 19, Fremont, OH 43420-1037 | 2010-02-27 |
| 1649601741 | Sandra Phillips | Pharmacist | 1825 N State Route 19, Fremont, OH 43420-1037 | 2013-11-29 |
| 1720377542 | Renae Michelle Linder | Pharmacist | 1825 N State Route 19, Kmart Pharmacy, Fremont, OH 43420-1037 | 2011-04-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225596570 | Trisha D Hamm | Nurse Practitioner | Walk In Urgent Care, 2180 Sean Dr., #6b, Fremont, OH 43420 | 2019-03-06 |
| 1558886051 | Kortney Blair Potridge | Homemaker | 1718 Buckland Avenue, Fremont, OH 43420 | 2017-08-07 |
| 1699134015 | Gentle Caring Dentistry of Fremont Ohio | Dentist | 2430 Enterprise St, Fremont, OH 43420 | 2016-02-12 |
| 1033574587 | Alyssa Dickman | Physical Therapy Assistant | 1310 Chestnut St, Fremont, OH 43420 | 2015-12-29 |
| 1437566734 | Michael Allen Koebel | Registered Nurse | 1728 Oak Harbor Rd, Fremont, OH 43420 | 2014-07-18 |
| 1598183774 | Harry D. Burger | Dentist | 567 Bartson Rd., Fremont, OH 43420 | 2014-04-03 |
| 1750706636 | Lori Fisher | Registered Nurse | 500 W. State St., Suite A, Fremont, OH 43420 | 2014-02-28 |
| 1699113001 | Cora Renea Minich | Massage Therapist | 510 Court Street, Fremont, OH 43420 | 2013-06-07 |
| 1477850071 | Parschauer Eye Center Inc | Eyewear Supplier (Equipment, not the service) | 126 S. Front St, Fremont, OH 43420 | 2011-02-16 |
| 1316260839 | Marla D Carlisle | Physician Assistant | 605 Third Avenue, Suite B, Fremont, OH 43420 | 2010-03-11 |
| Find all providers in zip 43420 | ||||
| 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 |
|---|---|---|---|---|
| 1568992857 | Lindenwood Rx, Inc | Pharmacy | 1860 Mowry Avenuew, Suite 102, Fremont, CA 94538-0300 | 2017-06-19 |
| 1770681827 | Grund Drug Co | Pharmacy | 227 S. Front St, Fremont, OH 43420 | 2006-09-20 |
| 1437261443 | Lewton and Assoc Health Care Service | Pharmacy | 824 W State St, Fremont, OH 43420-2538 | 2006-08-31 |
| 1548203862 | Longs Drug Stores California LLC | Pharmacy | 46445 Mission Blvd, Fremont, CA 94539-7909 | 2006-06-14 |
| 1881637676 | Longs Drug Stores California LLC | Pharmacy | 4020 Fremont Hub, Fremont, CA 94538-1322 | 2006-06-13 |
| 1609818426 | Longs Drug Stores California LLC | Pharmacy | 35720 Fremont Blvd, Fremont, CA 94536-3421 | 2006-06-13 |
| 1316498421 | Pansmart Inc | Pharmacy | 2557 Mowry Ave, Suite # 11, Fremont, CA 94538-1603 | 2016-10-24 |
| 1356699722 | Mowry Plaza Pharmacy Inc | Pharmacy | 668 Mowry Ave, Fremont, CA 94536-4113 | 2012-08-16 |
| 1518249432 | Walgreens | Pharmacy | 2600 Mowry Ave, Fremont, CA 94538-1619 | 2011-09-16 |
| 1891839965 | Save Mart Supermarkets | Pharmacy | 5000 Mowry Ave, Fremont, CA 94538-1045 | 2007-02-20 |
| Find all providers in FREMONT | ||||
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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.