K MART CORP (NPI# 1770514804) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770514804 |
| Entity Type | Organization |
| Organization Name | K MART CORP |
| Other Organization Name | KMART PHARMACY4986 |
| Practice Address |
3901 Holland Rd Virginia Beach VA 23452-2804 |
| Mailing Address |
3333 Beverly Rd Ac 367 B Hoffman Estates IL 60179-0001 |
| Practice Telephone | 7576312863 |
| Practice Fax Number | 7574981529 |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2008-10-10 |
| Authorized Official Name | ROBBERT AYSHFORD (DIRECTOR OF PHARMACY ADMINISTRATION) |
| Authorized Official Telephone | 8472868242 |
| 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 |
0201003333 | VA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | 8508054 | 05 | |
| NCPDP PROVIDER IDENTIFICATION NUMBER | 4829834 | 01 |
| Other Name | Type Code |
|---|---|
| KMART PHARMACY4986 | 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 |
3901 HOLLAND RD |
| City | VIRGINIA BEACH |
| State | VA |
| Zip Code | 23452-2804 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831284595 | Renato H Gecolea | Family Medicine | 3901 Holland Rd, Virginia Beach, VA 23452-2804 | 2006-10-04 |
| 1629609870 | Kathryn Hawse | Pharmacist | 3901 Holland Rd, Virginia Beach, VA 23452-2804 | 2020-01-27 |
| 1073153615 | Kyle E Crowell | Pharmacist | 3901 Holland Rd, Virginia Beach, VA 23452-2804 | 2020-01-12 |
| 1205220662 | Tien T Nguyen | Registered Nurse | 3901 Holland Rd, Virginia Beach, VA 23452-2804 | 2015-03-24 |
| 1922414523 | Lawren Williamson | Nurse Practitioner | 3901 Holland Rd, Virginia Beach, VA 23452-2804 | 2014-07-03 |
| 1033459995 | Kroger Limited Partnership I | Durable Medical Equipment & Medical Supplies | 3901 Holland Rd, Virginia Beach, VA 23452-2804 | 2013-02-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881208650 | Tracie Marie Romero | Counselor | 236 Mustag Trail Ste, Virginia Beach, VA 23452 | 2020-08-31 |
| 1346884400 | Asra R Javeed Dmd PC | Dentist | 4312 Holland Rd Ste 108, Virginia Beach, VA 23452 | 2019-11-01 |
| 1598313298 | Reach Orthotic & Prosthetic Service, Inc. | Prosthetic/Orthotic Supplier | 397 Little Neck Rd, Building 3400, Suite 107, Virginia Beach, VA 23452 | 2019-08-27 |
| 1205483229 | Brenna Dober | Behavior Technician | 380 Clevend Place, Virginia Beach, VA 23452 | 2019-08-23 |
| 1639652977 | Jessica Keefe | Psychologist | 642 Carriage Hill Road, Virginia Beach, VA 23452 | 2018-09-12 |
| 1316433709 | Circle of Life, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3630 S Plaza Trl Ste 210a, Virginia Beach, VA 23452 | 2018-07-09 |
| 1992205165 | Jeremy Monsanto | Behavior Technician | 629 Phoenix Drive, Ste 150, Virginia Beach, VA 23452 | 2018-02-14 |
| 1174056014 | Samantha Brown | Behavior Technician | 780 Nnhaven Parkway, Suite 400, Virginia Beach, VA 23452 | 2017-04-07 |
| 1043757685 | Join1,llc | Home Health | 349 Southport Circle, Suite 106, Virginia Beach, VA 23452 | 2017-01-20 |
| 1720520620 | Renee Brush | Psychologist | 485 S Independence Blvd Ste 104, Virginia Beach, VA 23452 | 2016-11-08 |
| Find all providers in zip 23452 | ||||
| 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 | 23452 |
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.