K MART CORP (NPI# 1871524876) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871524876 |
| Entity Type | Organization |
| Organization Name | K MART CORP |
| Other Organization Name | KMART PHARMACY3408 |
| Practice Address |
4801 Highway 58 Chattanooga TN 37416-1826 |
| Mailing Address |
3333 Beverly Rd Ac 367 B Hoffman Estates IL 60179-0001 |
| Practice Telephone | 4238993353 |
| Practice Fax Number | 4238939290 |
| Mailing Telephone | 8472864089 |
| Mailing Fax Number | 8472861603 |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2012-07-30 |
| Authorized Official Name | GHASSAN HOURANI (VP/GMM PHARMACY ADMIN) |
| Authorized Official Telephone | 8472863382 |
| 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 |
0000000196 | TN | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 4415433 | 05 | |
| NCPDP PROVIDER IDENTIFICATION NUMBER | 4415433 | 01 |
| Other Name | Type Code |
|---|---|
| KMART PHARMACY3408 | 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 |
4801 HIGHWAY 58 |
| City | CHATTANOOGA |
| State | TN |
| Zip Code | 37416-1826 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508190349 | Casey Robertson | Pharmacist | 4801 Highway 58, Chattanooga, TN 37416-1826 | 2009-09-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073170718 | A Pharmacy LLC | Pharmacy | 4767 Hwy 58, Suite 101, Chattanooga, TN 37416 | 2019-05-28 |
| 1639653835 | Paige Mayer | Pharmacist | 4542 Tn- 58, Chattanooga, TN 37416 | 2018-09-24 |
| 1528501517 | Tabitha Richelle Bell | Home Health | 6379 Plantation Dr, Chatt, TN 37416 | 2016-11-23 |
| 1588785109 | Mark Stephen Cowart | Dentist | 4355 Hwy 58, #103a, Chattanooga, TN 37416 | 2007-04-02 |
| 1558485334 | Robert Joseph Gallien | Dentist | 4620 Hwy 58, Chattanooga, TN 37416 | 2007-03-19 |
| 1154464782 | Carol Guess | Nurse Practitioner | 7380 Volkswagen Drive, Suite #110, Chattanooga, TN 37416 | 2007-02-14 |
| 1073615464 | Kristen Beeler Conner | Dentist | 4972 Highway 58 Ste 114, Chattanooga, TN 37416 | 2006-09-05 |
| 1003865536 | Stephen C Miller | Family Medicine | 7380 Volkswagon Drive, Suite 110, Chattanooga, TN 37416 | 2006-05-10 |
| 1740773241 | Nicholas Adam Jenkins | Physical Therapist | 7380 Volkswagen Dr Ste 190a, Chattanooga, TN 37416 | 2018-06-08 |
| 1639695034 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 4434 Highway 58, Chattanooga, TN 37416 | 2017-08-17 |
| Find all providers in zip 37416 | ||||
| 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 |
|---|---|---|---|---|
| 1811522485 | On Site Rx Inc | Pharmacy | 3074 Hickory Valley Rd Bldg 229, Chattanooga, TN 37421-1273 | 2020-03-04 |
| 1073170718 | A Pharmacy LLC | Pharmacy | 4767 Hwy 58, Suite 101, Chattanooga, TN 37416 | 2019-05-28 |
| 1982952917 | Carestar Pharmacy | Pharmacy | 6106 Shallowford Rd Ste 108, Chattanooga, TN 37421-2280 | 2012-08-23 |
| 1548584634 | Eastside Pharmacy Inc | Pharmacy | 6857 Lee Hwy, Chattanooga, TN 37421-6406 | 2010-03-18 |
| 1538342076 | Ross Enterprise Inc | Pharmacy | 2001 E Third St Suite C, Chattanooga, TN 37404-2610 | 2007-12-06 |
| 1417095407 | Custom Compounding Pharmacy LLC | Pharmacy | 3816 Ringgold Rd, Chattanooga, TN 37412-1640 | 2007-02-02 |
| 1699831966 | Deems S Riddle IIi | Pharmacy | 4335 Ringgold Rd, Chattanooga, TN 37412-2740 | 2006-12-29 |
| 1952496804 | Pulmonaire Service Pharmacy, Inc. | Pharmacy | 821 Mccallie Ave, Chattanooga, TN 37403-2613 | 2006-10-04 |
| 1215030911 | Tennessee Cvs Pharmacy LLC | Pharmacy | 5501 Brainerd Rd, Chattanooga, TN 37411-5309 | 2006-09-07 |
| 1306949003 | Tennessee Cvs Pharmacy LLC | Pharmacy | 5011 State St # A, Chattanooga, TN 37407-3519 | 2006-09-07 |
| Find all providers in CHATTANOOGA | ||||
| City | CHATTANOOGA |
| Zip Code | 37416 |
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.