KMART PHARMACY (NPI# 1790148492) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790148492 |
| Entity Type | Organization |
| Organization Name | KMART PHARMACY |
| Practice Address |
2110 S M 76 West Branch MI 48661-8737 |
| Practice Telephone | 9893454884 |
| Practice Fax Number | 8473962732 |
| Mailing Telephone | 9893454884 |
| Mailing Fax Number | 8473962732 |
| Enumeration Date | 2016-03-30 |
| Last Update Date | 2016-03-30 |
| Authorized Official Name | DR. BRIAN SCHUCK (PHARMACY DISTRICT MANAGER) |
| Authorized Official Telephone | 6163613649 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 333600000X | Pharmacy | 5301005457 | MI | Suppliers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073067278 | Kmart Pharmacy | Pharmacy | 161 Big Elk Mall, Elkton, MD 21921-5912 | 2016-08-05 |
| 1104270040 | Kmart Pharmacy | Pharmacist | 2965 Hemingway Lane, Lexington, KY 40513-0000 | 2016-04-18 |
| 1194188953 | Kmart Pharmacy | Pharmacist | 1801 W Alexis Rd, Toledo, OH 43613-2302 | 2016-03-30 |
| 1619386901 | Kmart Pharmacy | Pharmacy | 4000 East 2nd, Casper, WY 82609 | 2014-08-12 |
| 1386057677 | Kmart Pharmacy | Pharmacy | 1284 Brice Rd, Reynoldsburg, OH 43068-2311 | 2014-06-04 |
| 1104236843 | Kmart Pharmacy | Pharmacy | 1205 E Pine St, Deming, NM 88030-7038 | 2014-05-03 |
| 1588108757 | Kmart Pharmacy | Clinic/Center | 2600 Lincoln Way E, Massillon, OH 44646-5055 | 2016-12-07 |
| 1255787008 | Kmart Pharmacy | Case Management | 404 N Marine Corps Dr, Tamuning, GU 96913-4109 | 2016-05-11 |
| 1750735007 | Kmart Pharmacy | Pharmacy | 1308 W Walnut Ave, Dalton, GA 30720-3827 | 2016-04-22 |
| 1477907954 | Kmart Pharmacy | Pharmacy | 830 W Fulton St, Waupaca, WI 54981-1406 | 2016-04-20 |
| Street Address |
2110 S M 76 |
| City | WEST BRANCH |
| State | MI |
| Zip Code | 48661-8737 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740502012 | Phillip James Rembelski | Pharmacist | 2110 S M 76, West Branch, MI 48661-8737 | 2010-02-26 |
| 1033732391 | Mclaren Central Michigan | Clinic/Center | 2110 S M 76, West Branch, MI 48661-8737 | 2020-05-21 |
| 1811344153 | Brian James Bennett | Pharmacist | 2110 S M 76, West Branch, MI 48661-8737 | 2016-05-17 |
| 1982635975 | Kmart of Michigan Inc | Pharmacy | 2110 S M 76, West Branch, MI 48661-8737 | 2006-07-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992226773 | Linda Loou Thopmson | Registered Nurse | 335 E. Houghton Ave., West Branch, MI 48661 | 2017-06-30 |
| 1831559103 | Lisa J. Gutierrez | Counselor | 105 N. 3rd St., Ste 6, West Branch, MI 48661 | 2016-03-01 |
| 1497185383 | Linda Joy Latulip | Social Worker | 445 S. Valley, West Branch, MI 48661 | 2013-11-14 |
| 1376973289 | Patricia Woelke | Occupational Therapist | 335 East Houghton, West Branch, MI 48661 | 2013-11-14 |
| 1760731012 | Lucas John Wyzlic | Physician Assistant | 621 Court Street, Suite 104, West Branch, MI 48661 | 2012-08-31 |
| 1225312234 | Mark Bedtelyon | Pharmacist | 2480 E Houghton Ave, West Branch, MI 48661 | 2011-10-10 |
| 1790016632 | Stephanie M Witte-mason | Chiropractor | 2333 S M 76, West Branch, MI 48661 | 2010-01-15 |
| 1578798997 | Michael Robert Munger | Dietitian, Registered | 2897 Amanda Ct., West Branch, MI 48661 | 2009-05-29 |
| 1124261516 | Sarah C. Bryce | Pharmacist | 501 E. Houghton Ave, West Branch, MI 48661 | 2009-04-14 |
| 1528208303 | Richard K Braidwood | Pharmacist | 2206 S. M-76, West Branch, MI 48661 | 2009-03-06 |
| Find all providers in zip 48661 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |
| 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: added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689119901 | Fonguh Enterprises Inc | Pharmacy | 700 Columbus Ave, West Branch, MI 48661-8705 | 2016-12-22 |
| 1871939470 | Family Fare LLC | Pharmacy | 2206 S M 76, West Branch, MI 48661-9343 | 2013-05-22 |
| 1982635975 | Kmart of Michigan Inc | Pharmacy | 2110 S M 76, West Branch, MI 48661-8737 | 2006-07-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558961763 | Dustyn Daniel Thoney | Pharmacy | 530 Harding Ave, Iron River, MI 49935-2265 | 2020-10-27 |
| 1497355697 | Katherine Jane Cybulski | Pharmacy | 1310 Waukazoo St, Hastings, MI 49058-9559 | 2020-10-27 |
| 1043836042 | Hanan Pharmacy LLC | Pharmacy | 4600 E 14 Mile Road, Suite 2, Warren, MI 48092-1057 | 2020-06-25 |
| 1770104192 | Hazelwood Pharmacy LLC | Pharmacy | 624 E 9 Mile Rd Ste C, Hazel Park, MI 48030-1842 | 2020-04-27 |
| 1457980609 | Berkley Pharmacy LLC | Pharmacy | 28577 Schoenherr Road, Warren, MI 48088 | 2020-04-08 |
| 1669012316 | Warriors Pharmacy, Inc. | Pharmacy | 5265 Anthony Wayne Dr, Detroit, MI 48202-3947 | 2020-01-10 |
| 1457996662 | Sunrise Pharmacy, LLC | Pharmacy | 989 University Dr Ste 104, Pontiac, MI 48342-1885 | 2019-11-12 |
| 1447894019 | Nova Pharmacy | Pharmacy | 15140 Levan Rd, Suite 40, Livonia, MI 48154 | 2019-11-06 |
| 1912541673 | Wayne Pharma | Pharmacy | 974 Ford Ave, Wyandotte, MI 48192 | 2019-11-05 |
| 1639720667 | Grand Haven Pharmacy LLC | Pharmacy | 930 John R Rd Ste Pharmacy, Troy, MI 48083-4316 | 2019-09-20 |
| Find all providers with the same taxonomy | ||||
| City | WEST BRANCH |
| Zip Code | 48661 |
Please comment or provide details below to improve the information on KMART PHARMACY.
| 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.