K MART CORP (NPI# 1730110859) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730110859 |
| Entity Type | Organization |
| Organization Name | K MART CORP |
| Other Organization Name | KMART PHARMACY9511 |
| Practice Address |
111 Town and Country Dr Palatka FL 32177-3962 |
| Mailing Address |
3333 Beverly Rd Ac 367 B Hoffman Estates IL 60179-0001 |
| Practice Telephone | 3863257562 |
| Practice Fax Number | 3863260281 |
| 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 |
PH7104 | FL | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 104173800 | 05 | |
| PK | 2005581 | 01 |
| Other Name | Type Code |
|---|---|
| KMART PHARMACY9511 | 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 |
111 TOWN AND COUNTRY DR |
| City | PALATKA |
| State | FL |
| Zip Code | 32177-3962 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235461443 | Juliet M Wadsworth | Pharmacist | 111 Town and Country Dr, Palatka, FL 32177-3962 | 2010-02-12 |
| 1477878379 | Willard L Bass Jr. | Pharmacist | 111 Town and Country Dr, Palatka, FL 32177-3962 | 2010-04-02 |
| 1780906289 | Dawn K. Laido | Pharmacist | 111 Town and Country Dr, Palatka, FL 32177-3962 | 2010-02-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174124176 | Charlie Douglas | Pharmacist | 1024 South State Road 19, Pharmacy, Palatka, FL 32177 | 2020-11-05 |
| 1275090359 | Carol M Kazounis | Dietitian, Registered | 2801 Kennedy Strett, Palatka, FL 32177 | 2019-02-26 |
| 1447744768 | Pulido Internal Medicine | Nurse Practitioner | 700 Zeagler Drive, Suite 1, Palatka, FL 32177 | 2018-06-20 |
| 1063922656 | Ronald Michael Wendt | Nurse Practitioner | 3703 Crill Ave, Palatka, FL 32177 | 2017-10-09 |
| 1043560212 | Leslie Ann Lewis | Massage Therapist | 325 Poinsetta Ave, Palatka, FL 32177 | 2012-09-14 |
| 1285984963 | Walgreens | Pharmacy | 719 South State Road 19, Palatka, FL 32177 | 2012-09-11 |
| 1841549235 | Audrey M Russell | Pharmacy Technician | 719 Hwy 19 South, Palatka, FL 32177 | 2012-08-31 |
| 1194023838 | Sherry D. Michael | Licensed Practical Nurse | 330 Kay Larkin Dr., Palatka, FL 32177 | 2011-03-04 |
| 1083846364 | Patricia Kowalchuk | Occupational Therapy Assistant | 6050 St.johns Ave., Suite A, Palatka, FL 32177 | 2009-08-20 |
| 1609015320 | Robin Calhoun | Occupational Therapist | 611 Zeagler Dr., Palatka, FL 32177 | 2009-02-19 |
| Find all providers in zip 32177 | ||||
| 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 |
|---|---|---|---|---|
| 1285984963 | Walgreens | Pharmacy | 719 South State Road 19, Palatka, FL 32177 | 2012-09-11 |
| 1881964435 | Pinnacle Pharmaceutical Services | Pharmacy | 815 S Moody Rd # 3, Palatka, FL 32177-8417 | 2012-01-12 |
| 1336426089 | Atlas Medical Inc | Pharmacy | 5037 Crill Ave, Palatka, FL 32177-6812 | 2011-11-09 |
| 1477657328 | Holiday Cvs LLC | Pharmacy | 201 S State Road 19, Palatka, FL 32177-3937 | 2006-09-12 |
| 1750753935 | Angels Pharmacy II LLC | Pharmacy | 610 Zeagler Dr, Palatka, FL 32177-3811 | 2015-10-27 |
| 1720281116 | Rural Health Care, Inc. | Pharmacy | 1302 River St, Palatka, FL 32177-5042 | 2007-06-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649871583 | Florida Community Health Centers, Inc. | Pharmacy | 9576 S Us Highway 1, Port Saint Lucie, FL 34952-4217 | 2020-11-06 |
| 1053911883 | Nrc Pharmd Inc | Pharmacy | 2700 Immokalee Rd Ste 24, Naples, FL 34110-1437 | 2020-10-30 |
| 1073112116 | Hl72 LLC | Pharmacy | 5193 Clark Rd, Sarasota, FL 34233-3213 | 2020-10-20 |
| 1689280851 | Unique Pharmacy Corp | Pharmacy | 7800 Sw 87th Ave Ste 210b, Miami, FL 33173-2537 | 2020-09-22 |
| 1033723127 | Five Pillars Corporation | Pharmacy | 2301 N University Dr Ste 112, Pembroke Pines, FL 33024-3617 | 2020-09-04 |
| 1780297655 | Healthy Living Pharmacy LLC | Pharmacy | 755 Rosemary Cir, Bradenton, FL 34212-5015 | 2020-08-28 |
| 1326651555 | Purformance Wellness Pharmacy LLC | Pharmacy | 600 Se Indian St Ste 3, Stuart, FL 34997-5540 | 2020-08-27 |
| 1043822620 | Specialtycarerx LLC | Pharmacy | 821 N Us Highway 1 Ste A, Ormond Beach, FL 32174-4528 | 2020-08-17 |
| 1831700855 | Kingsley Rx LLC | Pharmacy | 1542 Kingsley Ave Ste 142, Orange Park, FL 32073-4547 | 2020-08-13 |
| 1104435742 | Easyscripts LLC | Pharmacy | 2601 S Military Trl Ste 1, West Palm Beach, FL 33415-7509 | 2020-07-29 |
| Find all providers with the same taxonomy | ||||
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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.