K MART CORP (NPI# 1821029976) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821029976 |
| Entity Type | Organization |
| Organization Name | K MART CORP |
| Other Organization Name | KMART PHARMACY7451 |
| Practice Address |
2078 State Rte 481 State 57 Fulton NY 13069 |
| Mailing Address |
3333 Beverly Rd Ac 367 B Hoffman Estates IL 60179-0001 |
| Practice Telephone | 3155989747 |
| Practice Fax Number | 3155982992 |
| Mailing Telephone | 8472864089 |
| Mailing Fax Number | 8472861603 |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2013-08-08 |
| Authorized Official Name | ELIZABETH ZANDER (DIRECTOR MANAGED CARE) |
| Authorized Official Telephone | 8472867661 |
| 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 |
022220 | NY | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2068212 | 01 | |
| NY | 01515159 | 05 |
| Other Name | Type Code |
|---|---|
| KMART PHARMACY7451 | 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 |
2078 STATE RTE 481 STATE 57 |
| City | FULTON |
| State | NY |
| Zip Code | 13069 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659499192 | Zaven K Balian | Pharmacist | 2078 State Rte 481 State 57, Fulton, NY 13069 | 2007-03-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588291454 | Awilda Vega Johnston | Counselor | 92 N. 2nd St., #100, Fulton, NY 13069 | 2020-03-23 |
| 1174169346 | Gabrielle Sunshine Chrestler | Technician | 2118 Co Rt 176, Fulton, NY 13069 | 2019-11-22 |
| 1558917310 | Renee Omsby | Technician | 1323 County Rte 9, Fullton, NY 13069 | 2019-08-16 |
| 1194208488 | Bridgette Lynn Godfrey | Registered Nurse | 167 South 4th Street, Fulton, NY 13069 | 2018-09-12 |
| 1205299195 | Nu-ops, Inc | Taxi | 107 West 4th St So, Fulton, NY 13069 | 2016-03-30 |
| 1770909061 | Siobhan Anne Walsh | Licensed Practical Nurse | 436 Rowlee Road, Fulton, NY 13069 | 2014-03-11 |
| 1982971743 | Jennifer Lynn Scaringi | Licensed Practical Nurse | 505 Seneca St, Fulton, NY 13069 | 2011-11-22 |
| 1215242680 | Meghan Kathleen Hill | Physical Therapist | 706 South 4th St, Fulton, NY 13069 | 2010-08-10 |
| 1659699064 | Daniel Petrescu | Physical Therapist | 453 Park St., Michaud Residential Healthcare, Fulton, NY 13069 | 2010-05-10 |
| 1528212842 | Robyn Elizabeth Mccann | Licensed Practical Nurse | 464 Red School House Road, Fulton, NY 13069 | 2008-11-13 |
| Find all providers in zip 13069 | ||||
| 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 |
|---|---|---|---|---|
| 1679806517 | Harris Teeter, LLC | Pharmacy | 8184 Westside Blvd, Fulton, MD 20759-2587 | 2009-09-10 |
| 1255434569 | Kph Healthcare Services, Inc. | Pharmacy | 115 Oneida St, Fulton, NY 13069-1227 | 2006-09-06 |
| 1639437312 | Maryland Cvs Pharmacy LLC | Pharmacy | 8197 Westside Blvd, Fulton, MD 20759-2590 | 2012-05-01 |
| 1689794547 | Hargraves Pharmacy Inc. | Pharmacy | 113 W Broadway, Fulton, NY 13069-2215 | 2007-04-01 |
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|---|---|---|---|---|
| 1891396388 | Sharx Corp | Pharmacy | 4301 48th Ave, Woodside, NY 11377-6241 | 2020-11-03 |
| 1841890878 | Corner Pharmacy Myrtle | Pharmacy | 680 Myrtle Ave, Brooklyn, NY 11205-4119 | 2020-10-28 |
| 1124627302 | Elite Pharmacy Inc. | Pharmacy | 614a Grand St, Brooklyn, NY 11211-4802 | 2020-10-20 |
| 1073111951 | Pharmacy On Bay Street Inc. | Pharmacy | 1209 Bay St, Staten Island, NY 10305-3121 | 2020-10-13 |
| 1760080741 | Carol Pharmacy LLC | Pharmacy | 4230 Broadway, New York, NY 10033-3746 | 2020-10-13 |
| 1528666443 | Mvp Pharmacy Inc | Pharmacy | 920 Wheeler Rd Ste 920, Hauppauge, NY 11788-2900 | 2020-10-13 |
| 1477151512 | 101 Rx Pharmacy Inc | Pharmacy | 101 Rx Pharmacy Inc, 9718 101st Ave, Ozone Park, NY 11416 | 2020-10-12 |
| 1043818289 | Xuwei Lin | Pharmacy | 8218 14th Ave, Brooklyn, NY 11228-3114 | 2020-10-10 |
| 1043817463 | Angella Samson | Pharmacy | 1346 Granville Payne Ave, Brooklyn, NY 11239-2103 | 2020-10-08 |
| 1366059792 | Community Healthcare Network Inc. | Pharmacy | 999 Blake Ave Fl 1, Brooklyn, NY 11208-3535 | 2020-09-29 |
| 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.