K MART CORP (NPI# 1932130903) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932130903 |
| Entity Type | Organization |
| Organization Name | K MART CORP |
| Other Organization Name | KMART PHARMACY3447 |
| Practice Address |
10331 University Ave Clive IA 50325-6472 |
| Mailing Address |
3333 Beverly Rd Ac 367 B Hoffman Estates IL 60179-0001 |
| Practice Telephone | 5152252694 |
| Practice Fax Number | 5152220813 |
| Mailing Telephone | 8472864089 |
| Mailing Fax Number | 8472861603 |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2014-10-30 |
| Authorized Official Name | DAIN RUSK (VP/GM PHARMACY) |
| Authorized Official Telephone | 8472863348 |
| 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 |
1016 | IA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2029596 | 01 | |
| IA | 0157545 | 05 |
| Other Name | Type Code |
|---|---|
| KMART PHARMACY3447 | 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 |
10331 UNIVERSITY AVE |
| City | CLIVE |
| State | IA |
| Zip Code | 50325-6472 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780906958 | Paula Renee Logue | Pharmacist | 10331 University Ave, Clive, IA 50325-6472 | 2010-02-15 |
| 1598087322 | Keith J Zierke | Pharmacist | 10331 University Ave, Clive, IA 50325-6472 | 2010-02-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104449446 | Clive Behavioral Health LLC | Psychiatric Hospital | 1500 Nw 114th St, Clive, IA 50325 | 2020-05-21 |
| 1609426519 | Caroline Silva Pereira Lara Ribeiro | Occupational Therapist | 15500 Boston Parkway, Appt 110, Clive, IA 50325 | 2019-09-13 |
| 1487203873 | Karen Turnure | Technician | 4524 Nw 16th St, Clive, IA 50325 | 2019-09-09 |
| 1659920320 | Phs Walnut Ridge LLC | Skilled Nursing Facility | 1703 Campus Drive, Clive, IA 50325 | 2019-09-05 |
| 1700288834 | Lindsey White | Chiropractor | 12931 University Ave, Suite 103, Clive, IA 50325 | 2014-09-19 |
| 1811337389 | Metro West Learning Center, LLC | Counselor | 13300 Hickman Rd Ste 110, Clive, IA 50325 | 2013-06-28 |
| 1700110343 | Rodolfo Mallorca Legislador Sr. | Family Medicine | 1665 Nw 97th St., Clive, IA 50325 | 2009-09-30 |
| 1891961900 | Erin Ducharme | Dermatology | 16349 Sheridan Drive, Suite 101, Clive, IA 50325 | 2008-05-08 |
| 1174792873 | The Iowa Clinic PC | Prosthetic/Orthotic Supplier | 12655 University Ave, Ste 160, Clive, IA 50325 | 2008-02-27 |
| 1164623393 | Melisa Coaker | Internal Medicine | 1275 Nw 128th St, Ste 200, Clive, IA 50325 | 2007-05-28 |
| Find all providers in zip 50325 | ||||
| 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 |
|---|---|---|---|---|
| 1194889477 | Dgs-acquisitions LLC | Pharmacy | 15500 Hickman Rd, Clive, IA 50325-7983 | 2006-12-20 |
| 1356374623 | Foods, Inc | Pharmacy | 8700 Hickman Rd, Clive, IA 50325-4326 | 2006-07-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013546308 | Hy Vee Inc | Pharmacy | 911 S K Ave, Vinton, IA 52349-1073 | 2020-04-07 |
| 1164050944 | Corridor Pharmacy | Pharmacy | 650 W Cherry St Ste 7, North Liberty, IA 52317-9025 | 2020-03-29 |
| 1932740024 | St Luke's Jones Regional Medical Center | Pharmacy | 1795 Highway 64 E Ste 2, Anamosa, IA 52205-2112 | 2019-10-01 |
| 1316407018 | Harlan Pharmacy, LLC | Pharmacy | 1024 5th St, Harlan, IA 51537-1427 | 2019-03-20 |
| 1306304027 | State University of Iowa | Pharmacy | 1360 N Dodge St Ste 1100, Iowa City, IA 52245-6104 | 2019-03-12 |
| 1265999387 | Bancroft Apothecary Lp | Pharmacy | 106 W Ramsey St, Bancroft, IA 50517-8078 | 2019-02-25 |
| 1023588159 | Mark Oleson | Pharmacy | 1100 Broad Street, Adair, IA 50002 | 2018-12-02 |
| 1598235723 | Cjk Pharmacy, LLC | Pharmacy | 3100 E Ave Nw Ste 102, Cedar Rapids, IA 52405-2962 | 2018-11-30 |
| 1144701582 | Madsen Inc | Pharmacy | 307 2nd. St., Gladbrook, IA 50635-5063 | 2018-08-23 |
| 1376024869 | Hy Vee Inc | Pharmacy | 3285 Crosspark Road, Coralville, IA 52241 | 2018-08-23 |
| 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.