KMART CORP (NPI# 1871600791) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871600791 |
| Entity Type | Organization |
| Organization Name | KMART CORP |
| Other Organization Name | KMART PHARMACY |
| Practice Address |
344 Highway 90 Waveland MS 39576-2672 |
| Mailing Address |
3333 Beverly Rd Ac 367 B Hoffman Estates IL 60179-0001 |
| Practice Telephone | 2284676804 |
| Mailing Telephone | 8472862527 |
| Mailing Fax Number | 8472861603 |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2013-08-09 |
| 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 |
|---|---|---|---|---|---|
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
02067/01.2 | MS | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 00786059 | 05 | |
| PK | 2045100 | 01 |
| Other Name | Type Code |
|---|---|
| KMART PHARMACY | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Vermont Business Registrations | KMART CORPORATION | 3333 Beverly Rd., Hoffman Estates, IL 60179 |
| Oklahoma Business Registrations | KMART CORPORATION | 3100 W. Big Beaver Rd., Troy, MI 48084 |
| Street Address |
344 HIGHWAY 90 |
| City | WAVELAND |
| State | MS |
| Zip Code | 39576-2672 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235451527 | Myra Marie Campbell | Pharmacist | 344 Highway 90, Waveland, MS 39576-2672 | 2010-02-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649817917 | Sharon Angels Homecare LLC | Home Health | 2208 Mclaurin St., Waveland, MS 39576 | 2019-12-05 |
| 1538410105 | Hancock Medical Health Services | Nurse Practitioner | 1101 St. Joseph St., Waveland, MS 39576 | 2012-09-24 |
| 1326321506 | Wesley Leroy Mcfarland | Family Medicine | 417 Old Spanish Trail, Waveland, MS 39576 | 2011-09-23 |
| 1073874194 | Natisha Reynoso | Developmental Therapist | 210 Dogwood St, Waveland, MS 39576-2003 | 2012-06-05 |
| 1700991288 | Leland Kendrick | Family Medicine | 1903 Waveland Ave, Waveland, MS 39576-2319 | 2006-08-21 |
| 1316066475 | Thomas Beatty Murphree Jr. | Dentist | 110 Auderer Blvd, Waveland, MS 39576-2432 | 2007-03-28 |
| 1679507644 | Waveland Pharmacy LLC | Pharmacy | 112 Auderer Blvd, Waveland, MS 39576-2432 | 2006-07-10 |
| 1548559586 | Waveland Dental Center Pllc | Dentist | 110 Auderer Blvd, Waveland, MS 39576-2432 | 2011-03-30 |
| 1336346113 | Waveland Dental Centerpllc | Dentist | 110 Auderer Blvd, Waveland, MS 39576-2432 | 2007-06-27 |
| 1972150860 | Christa M Hosey | Nurse Practitioner | 451 Highway 90, Waveland, MS 39576-2507 | 2019-08-24 |
| Find all providers in zip 39576 | ||||
| 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 |
|---|---|---|---|---|
| 1730355694 | Walgreen Co | Pharmacy | 348 Highway 90, Waveland, MS 39576-2672 | 2008-05-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164038485 | Quinn's Family Pharmacy of Newton | Pharmacy | 193 Northside Dr, Newton, MS 39345-9523 | 2020-09-22 |
| 1194339275 | Friendship, LLC | Pharmacy | 4123 W Main St, Tupelo, MS 38801 | 2020-09-04 |
| 1649883844 | Natchez Wellness Pharmacy | Pharmacy | 29 Sergeant Prentiss Dr Ste 5, Natchez, MS 39120-4743 | 2020-08-26 |
| 1952910366 | Ct Stamps Inc | Pharmacy | 206 Marion Avenue, Mccomb, MS 39648 | 2020-07-31 |
| 1114566122 | Valley Drugs, Inc. | Pharmacy | 327b S Main St, Water Valley, MS 38965-3318 | 2019-12-23 |
| 1851939318 | Smith Pharmacy, Inc. | Pharmacy | 306 Northside Drive, Newton, MS 39345 | 2019-12-16 |
| 1285270801 | Proxsys Rx - Rush LLC | Pharmacy | 14916 Hwy 16 W, Unit #1, Dekalb, MS 39328 | 2019-11-19 |
| 1518501592 | Southwest Pharmacy Inc | Pharmacy | 3000 Plaza Dr Ste B, Tylertown, MS 39667-9227 | 2019-11-01 |
| 1669015210 | Hometown Family Pharmacy, Inc. | Pharmacy | 930 Hall St Ste H, Wiggins, MS 39577-2113 | 2019-10-25 |
| 1225671001 | A & A Infusion & Specialty, LLC | Pharmacy | 124 E Jackson St, Belzoni, MS 39038-3642 | 2019-10-23 |
| 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.