KMART OPERATIONS LLC (NPI# 1912938911) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912938911 |
| Entity Type | Organization |
| Organization Name | KMART OPERATIONS LLC |
| Other Organization Name | KMART PHARMACY3775 |
| Practice Address |
1305 Highway 10 W Detroit Lakes MN 56501-2214 |
| Mailing Address |
3333 Beverly Rd Ac 367 B Hoffman Estates IL 60179-0001 |
| Practice Telephone | 2188479755 |
| Practice Fax Number | 2188479756 |
| Mailing Telephone | 8472864089 |
| Mailing Fax Number | 8472861603 |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2016-07-07 |
| 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 |
261183 | MN | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2046726 | 01 | |
| MN | 271018800 | 05 |
| Other Name | Type Code |
|---|---|
| KMART PHARMACY3775 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346271475 | Kmart Operations LLC | Pharmacy | 4700 2nd Ave, Kearney, NE 68847-2418 | 2006-07-06 |
| 1174554281 | Kmart Operations LLC | Pharmacy | 2821 E Main St, Russellville, AR 72802-9662 | 2006-07-06 |
| 1982635009 | Kmart Operations LLC | Pharmacy | 2308 Highway 45 N, Columbus, MS 39705-1745 | 2006-07-06 |
| 1982635033 | Kmart Operations LLC | Pharmacy | 1425 E Highway 151, Platteville, WI 53818 | 2006-07-06 |
| 1245261395 | Kmart Operations LLC | Pharmacy | 2150 S Douglas Hwy, Gillette, WY 82718-5416 | 2006-07-06 |
| 1174554208 | Kmart Operations LLC | Durable Medical Equipment & Medical Supplies | 3180 Highway 2 West, Havre, MT 59501 | 2006-07-06 |
| 1427089416 | Kmart Operations LLC | Pharmacy | 1560 Us Highway 31 S, Manistee, MI 49660-2223 | 2006-07-06 |
| 1417988536 | Kmart Operations LLC | Pharmacy | 11 S Kingshighway St # 61, Cape Girardeau, MO 63703-5742 | 2006-07-06 |
| 1366473472 | Kmart Operations LLC | Pharmacy | 2011 E Fry Blvd, Sierra Vista, AZ 85635-2753 | 2006-07-06 |
| 1164453122 | Kmart Operations LLC | Pharmacy | 3101 Northview Dr, Elkhart, IN 46514-6748 | 2006-07-06 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Iowa Business Entities | KMART OPERATIONS LLC | 3333 Beverly Rd B2126b, Hoffman Estates, IL 60179 |
| Oregon Corporations, Companies and Business Names | KMART OPERATIONS LLC | 3333 Beverly Rd B2-101b, Hoffman Estates, IL 60179 |
| Washington State Corporations | KMART OPERATIONS LLC | 3333 Beverly Rd, Hoffman Est, IL 60179-0001 |
| New York State Corporations | KMART OPERATIONS LLC | 28 Liberty St., New York, Ny 10005 |
| Colorado Business Entities | Kmart Operations LLC | 3333 Beverly Road, B2-116b, Hoffman Estates, IL 60179 |
| Massachusetts Corporations | KMART OPERATIONS LLC | 3333 Beverly Rd. B2-126b, Hoffman Estates, IL 60179 |
| Indiana Business Entities | KMART OPERATIONS LLC | 3333 Beverly Rd, B2-126b, Hoffman Estates, IL 60179 |
| Street Address |
1305 HIGHWAY 10 W |
| City | DETROIT LAKES |
| State | MN |
| Zip Code | 56501-2214 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205073822 | Julie A Kauffman | Pharmacist | 1305 Highway 10 W, Detroit Lakes, MN 56501-2214 | 2009-01-20 |
| 1609239326 | Douglas Kaasa | Pharmacist | 1305 Highway 10 W, Detroit Lakes, MN 56501-2214 | 2016-03-31 |
| 1730598723 | Derek Gaffney | Pharmacist | 1305 Highway 10 W, Detroit Lakes, MN 56501-2214 | 2014-08-05 |
| 1316204365 | Daniel W Fougner | Pharmacist | 1305 Highway 10 W, Detroit Lakes, MN 56501-2214 | 2012-04-16 |
| 1124330899 | Gary Dean Domier | Pharmacist | 1305 Highway 10 W, Detroit Lakes, MN 56501-2214 | 2010-07-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588265649 | Candace Louise Haugtvedt | Pharmacist | 321 Us-10 West, Detroit Lakes, MN 56501 | 2020-11-05 |
| 1679068407 | Strive Chiropractic Detroit Lakes LLC | Chiropractor | 1852 Nodaway Drive, Detroit Lakes, MN 56501 | 2018-06-25 |
| 1194215830 | Jordan James Reese | Registered Nurse | 1295 Bay Ridge Dr, Detroit Lakes, MN 56501 | 2018-05-17 |
| 1992179386 | Compassion House | Substance Abuse Rehabilitation Facility | 811 8th St. Se, Detroit Lakes, MN 56501 | 2015-11-23 |
| 1720344286 | Lakes Crisis & Resource Center | Clinic/Center | 1339 Pelican Lane, Detroit Lakes, MN 56501 | 2012-04-09 |
| 1063657120 | Diane Jean Mccormack | Occupational Therapist | 15840 Long Lake Road, Detroit Lakes, MN 56501 | 2008-12-03 |
| 1588817928 | Darcy Caleb Olson | Counselor | 925 Lake Ave, Detroit Lakes, MN 56501 | 2008-10-29 |
| 1760651079 | Rapidcare Urgent Care Pllc | Family Medicine | 1361 Wenner Road, Detroit Lakes, MN 56501 | 2008-02-21 |
| 1427274729 | Jeffrey C Gregory | Psychologist | 910 Lincoln Ave, Detroit Lakes, MN 56501 | 2007-04-17 |
| 1144364894 | Midwest Vision Centers Inc | Eyewear Supplier (Equipment, not the service) | 830 Washington Avenue, Detroit Lakes, MN 56501 | 2007-02-16 |
| Find all providers in zip 56501 | ||||
| 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 |
|---|---|---|---|---|
| 1568789121 | Sanford Clinic North | Pharmacy | 1245 Washington Ave, Detroit Lakes, MN 56501-3905 | 2010-04-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497368633 | Sawtooth Mountain Clinic, Inc. | Pharmacy | 513 5th Ave W Rm 201, Grand Marais, MN 55604-3017 | 2020-08-27 |
| 1891313326 | Rochester Community Pharmacy LLC | Pharmacy | 1604 1st St Nw, Rochester, MN 55901-0318 | 2020-07-10 |
| 1134745730 | Elko New Market Family Pharmacy, LLC | Pharmacy | 117 Old Town Road, Elko New Market, MN 55054 | 2020-06-19 |
| 1578187456 | Coborns Inc | Pharmacy | 15700 88th St Ne, Otsego, MN 55330 | 2020-06-05 |
| 1205460169 | Genoa Healthcare, LLC | Pharmacy | 1515 Energy Park Dr Ste 110, Saint Paul, MN 55108-5229 | 2020-02-28 |
| 1801438361 | The Duluth Clinic, Ltd. | Pharmacy | 2 Division St Ste A, Deer River, MN 56636-8779 | 2019-10-16 |
| 1265084792 | Nudak Ventures, LLC | Pharmacy | 5418 Saint Croix Trl, North Branch, MN 55056-4203 | 2019-07-15 |
| 1659938116 | Sterlingrx Inc | Pharmacy | 1312 Northland Dr Ste 500, Mendota Heights, MN 55120-1436 | 2019-05-21 |
| 1639734346 | Seward Pharmacy LLC | Pharmacy | 2209 E Lake St, Minneapolis, MN 55407-4563 | 2019-05-08 |
| 1093370694 | Minnesota Ave N Pharmacy Services Limited | Pharmacy | 226 Minnesota Ave N, Aitkin, MN 56431-1412 | 2019-05-08 |
| Find all providers with the same taxonomy | ||||
| City | DETROIT LAKES |
| Zip Code | 56501 |
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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.