K MART CORP (NPI# 1699706721) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699706721 |
| Entity Type | Organization |
| Organization Name | K MART CORP |
| Other Organization Name | KMART PHARMACY4478 |
| Practice Address |
1061 White Horse Ave Trenton NJ 08610-1400 |
| Mailing Address |
3333 Beverly Rd Ac 367 B Hoffman Estates IL 60179-0001 |
| Practice Telephone | 6095812583 |
| Practice Fax Number | 6095855086 |
| 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 |
28RS0045860 | NJ | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2051917 | 01 | |
| NJ | 5058805 | 05 |
| Other Name | Type Code |
|---|---|
| KMART PHARMACY4478 | 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 |
| Massachusetts Corporations | K MART CORPORATION | 3333 Beverly Road, Hoffman Estates, IL 60179 |
| Street Address |
1061 WHITE HORSE AVE |
| City | TRENTON |
| State | NJ |
| Zip Code | 08610-1400 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356626923 | Sachin Patel | Pharmacist | 1061 White Horse Ave, Trenton, NJ 08610-1400 | 2011-10-14 |
| 1548711047 | Vivian Y Wu | Pharmacist | 1061 White Horse Ave, Trenton, NJ 08610-1400 | 2016-10-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710486766 | Merakey New Jersey | Community/Behavioral Health | 216 Borden Ave, Hamilton, NJ 08610 | 2018-02-06 |
| 1740641315 | Christiana Adiyiah Manu | Nurse Practitioner | 445 White Horse Ave Suit 202, Hamilton, NJ 08610 | 2016-03-10 |
| 1306226121 | Clinton Rebello | Military Health Care Provider | Mcguire Afb, Apo, AA 08610 | 2015-06-06 |
| 1780932848 | Lindsay Helen Hutchinson | Social Worker | 311 White Horse Ave Ste C, Hamilton, NJ 08610 | 2012-08-21 |
| 1366745176 | Family Care Physicians, LLC | Pediatrics | 445 Whitehorse Ave., Suites 100-101, Hamilton, NJ 08610 | 2010-12-16 |
| 1134454200 | Anna Marie Cesnik | Occupational Therapist | 1900 Arena Drive, Hamilton, NJ 08610 | 2009-10-07 |
| 1003014663 | South Broad Street Counseling Services Inc | Clinic/Center | 1418 South Broad Street, Trenton, NJ 08610 | 2007-07-05 |
| 1235341371 | Liberty Healthcare Services | Home Health | 1603 South Broad Street, Hamilton, NJ 08610 | 2007-05-03 |
| 1841312055 | Ziad Hadaya | Internal Medicine | 994 Whitehorse Ave, Hamilton, NJ 08610 | 2007-04-06 |
| 1487704193 | Marion Levy Bergman | Social Worker | 89 Marshall Ave, Hamilton, NJ 08610 | 2007-01-12 |
| Find all providers in zip 08610 | ||||
| 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 |
|---|---|---|---|---|
| 1003479577 | Aml Ibrahim Fawzy | Pharmacy | 2108 S Broad St, Trenton, NJ 08610-5502 | 2019-04-19 |
| 1891277711 | Glendale Village Pharmacy, LLC | Pharmacy | 334 S Broad St, Trenton, NJ 08608-2502 | 2018-09-06 |
| 1215447149 | Ridha Ahmed | Pharmacy | 635 S Clinton Ave Ste 400, Trenton, NJ 08611-1831 | 2017-10-05 |
| 1790140192 | Sg Health | Pharmacy | 503 S Olden Ave, Trenton, NJ 08629-2102 | 2015-12-29 |
| 1619385622 | Zoobeedu, Inc | Pharmacy | 359 Pennington Ave, Trenton, NJ 08618-3615 | 2014-07-23 |
| 1548602758 | Freds Stores of Tennessee Inc. | Pharmacy | 11858 S Main St, Trenton, GA 30752 | 2013-07-29 |
| 1609211689 | Kaplan Group LLC | Pharmacy | 828 N Olden Ave, Trenton, NJ 08638-4902 | 2013-05-06 |
| 1124348305 | Smash Medicine LLC | Pharmacy | 836 Martin Luther King Jr Blvd, Trenton, NJ 08638-4002 | 2010-06-10 |
| 1215163050 | Kaplan Group LLC | Pharmacy | 521 S Broad St, Trenton, NJ 08611-1819 | 2009-06-08 |
| 1962681858 | Saker Shoprites Inc | Pharmacy | 1225 Highway 33, Trenton, NJ 08690-2713 | 2007-10-29 |
| Find all providers in TRENTON | ||||
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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.