K MART CORP (NPI# 1831120948) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831120948 |
| Entity Type | Organization |
| Organization Name | K MART CORP |
| Other Organization Name | KMART PHARMACY3329 |
| Practice Address |
12412 Us Highway 19 Hudson FL 34667-1950 |
| Mailing Address |
3333 Beverly Rd Ac 367 B Hoffman Estates IL 60179-0001 |
| Practice Telephone | 7278635608 |
| Practice Fax Number | 7278198918 |
| 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 |
PH6399 | FL | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2009272 | 01 | |
| FL | 109447500 | 05 |
| Other Name | Type Code |
|---|---|
| KMART PHARMACY3329 | 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 |
12412 US HIGHWAY 19 |
| City | HUDSON |
| State | FL |
| Zip Code | 34667-1950 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114249497 | Raymond Draganchuk | Pharmacist | 12412 Us Highway 19, Hudson, FL 34667-1950 | 2010-02-27 |
| 1629424015 | Jane Griggs | Pharmacist | 12412 Us Highway 19, Hudson, FL 34667-1950 | 2016-05-04 |
| 1487976767 | Sheila Kennedy | Pharmacy Technician | 12412 Us Highway 19, Hudson, FL 34667-1950 | 2010-02-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417571431 | Andrea E Steyer | Speech-Language Pathologist | 7927 Sr-52 W, Hudson, FL 34667 | 2020-06-05 |
| 1760956288 | Helen Edith Yaworski | Emergency Medicine | Bayonet Point Emergency Department, 14000 Fivay Rd, Hudson, FL 34667 | 2019-01-17 |
| 1104308329 | Mark Felix Roldan | Nurse Practitioner | 13944 Lakeshore Blvd Ste C, Hudson, FL 34667 | 2018-09-04 |
| 1285181867 | Dawnlee Basile-wood | Counselor | 9416 Dibot Court, Hudson, FL 34667 | 2016-09-01 |
| 1679951321 | Joseph Robbins | Internal Medicine | 14000 Fivay Road, Hudson, FL 34667 | 2015-05-14 |
| 1043602733 | Martiale Faustin | Registered Nurse | 12715 Clock Tower Pkwy, Hudson, FL 34667 | 2015-03-04 |
| 1720418015 | Olive Spoeth | Assisted Living Facility | 8711 Cutlass Dr., Hudson, FL 34667 | 2013-11-22 |
| 1891093365 | Saxon Rehab Management LLC. | Occupational Therapist | 12404 Cobblestone Dr, Hudson, FL 34667 | 2011-03-08 |
| 1174768055 | Anthony Charles Stover | Behavioral Analyst | 14610 Conner Drive, Hudson, FL 34667 | 2008-12-08 |
| 1356594451 | Jill Bona Garcia | Speech-Language Pathologist | 11820 Denton Ave, Hudson, FL 34667 | 2008-11-03 |
| Find all providers in zip 34667 | ||||
| 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 |
|---|---|---|---|---|
| 1710517495 | Mmg Pharma LLC Cross Pharmacy | Pharmacy | 7306 State Road 52 Ste 4, Hudson, FL 34667-6750 | 2020-01-22 |
| 1942652110 | Oxford Pharmacy LLC | Pharmacy | 12134 Us Highway 19, Hudson, FL 34667-2058 | 2016-07-12 |
| 1669869376 | Lily Care LLC | Pharmacy | 8811 State Road 52 Ste 11, Hudson, FL 34667-6751 | 2015-04-20 |
| 1518202878 | Save N Care LLC | Pharmacy | 13850 Little Rd, Hudson, FL 34667-8025 | 2012-11-27 |
| 1669797569 | Avs Pharma LLC | Pharmacy | 7535 Medical Dr Unit 1, Hudson, FL 34667-6502 | 2010-04-02 |
| 1295835635 | Cvs Manchester Nh, L.L.C. | Pharmacy | 46 Morgan Rd, Hudson, NH 03051-3669 | 2006-09-25 |
| 1932203692 | Cvs Albany LLC | Pharmacy | 617 Warren St, Hudson, NY 12534-2813 | 2006-09-12 |
| 1083718985 | Holiday Cvs LLC | Pharmacy | 12015 Little Rd, Hudson, FL 34667-2922 | 2006-09-12 |
| 1144324120 | Holiday Cvs LLC | Pharmacy | 13839 Little Rd, Hudson, FL 34667-8026 | 2006-09-12 |
| 1285737940 | Ohio Cvs Stores LLC | Pharmacy | 5783 Darrow Rd, Hudson, OH 44236-3866 | 2006-09-07 |
| Find all providers in HUDSON | ||||
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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.