K MART CORP (NPI# 1952332009) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952332009 |
| Entity Type | Organization |
| Organization Name | K MART CORP |
| Other Organization Name | KMART PHARMACY3189 |
| Practice Address |
1813 Caldwell Blvd Nampa ID 83651-1505 |
| Mailing Address |
3333 Beverly Rd Ac 367 B Hoffman Estates IL 60179-0001 |
| Practice Telephone | 2084664521 |
| Practice Fax Number | 2084666140 |
| 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 |
575CP | ID | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | 0002621 | 05 | |
| ID | 013D575 | 05 | |
| PK | 2020466 | 01 |
| Other Name | Type Code |
|---|---|
| KMART PHARMACY3189 | 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 |
1813 CALDWELL BLVD |
| City | NAMPA |
| State | ID |
| Zip Code | 83651-1505 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457673741 | Michael Rixford Proudfoot | Pharmacist | 1813 Caldwell Blvd, Nampa, ID 83651-1505 | 2010-02-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376090985 | Stephen Michael Wren | Physician Assistant | 11035 W Karcher Rd, Nampa, ID 83651 | 2016-09-01 |
| 1104203157 | Jeremy Thorson | Social Worker | 456 West Orchard Ave., Apt D305, Nampa, ID 83651 | 2015-04-29 |
| 1134527708 | Community Health Clinics Inc | Clinic/Center | 207 1st Street S, Nampa, ID 83651 | 2014-12-15 |
| 1326455429 | Michelle Murchie | Pharmacist | 175 S. Middleton Rd, Nampa, ID 83651 | 2014-07-21 |
| 1700215373 | Stanley A Gillett | Chiropractor | 107 14th Ave S, Nampa, ID 83651 | 2013-11-04 |
| 1477996205 | James L Fries | Counselor | 847 Park Centre Way, Suite 5, Nampa, ID 83651 | 2013-04-11 |
| 1023367240 | Erin Westfall | Speech-Language Pathologist | 168 Mcclure Avenue, Nampa, ID 83651 | 2012-09-04 |
| 1487949475 | Erik Steven Linn | Family Medicine | 11035 W. Karcher Road, Nampa, ID 83651 | 2011-06-17 |
| 1720398647 | At Your Service Home Health Care LLC | In Home Supportive Care | 321 2nd St S Ste 103, Nampa, ID 83651 | 2010-10-13 |
| 1144544206 | Petra Morrison | Community/Behavioral Health | 1031 W. Sanetta St., Nampa, ID 83651 | 2010-03-18 |
| Find all providers in zip 83651 | ||||
| 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 |
|---|---|---|---|---|
| 1851485106 | Costco Wholesale Corporation | Pharmacy | 16700 N Market Place Blvd, Nampa, ID 83687 | 2006-10-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295336709 | Family Health Services Pharmacy | Pharmacy | 218 W. Nez Perce, Jerome, ID 83338 | 2020-11-03 |
| 1841806494 | Deblaquiere Enterprises, Inc. | Pharmacy | 86 Tank Rd, Oldtown, ID 83822-5126 | 2020-09-18 |
| 1043838584 | Costco Wholesale Corporation | Pharmacy | 3403 W Chinden Blvd, Meridian, ID 83646-7151 | 2020-07-10 |
| 1265054324 | Costco Wholesale Corporation | Pharmacy | 2495 E Lincoln Rd, Idaho Falls, ID 83401-2203 | 2020-05-12 |
| 1851923544 | Rocky Mountain Pharmacy, LLC | Pharmacy | 3910 Washington Pkwy Ste A, Idaho Falls, ID 83404-7884 | 2020-02-10 |
| 1013559269 | Timberline Pharmacy | Pharmacy | 4574 N Ten Mile Rd Ste 110, Meridian, ID 83646-6930 | 2019-10-09 |
| 1508420373 | K2red LLC | Pharmacy | 447 N Idaho St, Wendell, ID 83355 | 2019-04-27 |
| 1679039135 | Hollis Family Pharmacy LLC | Pharmacy | 845 S Substation Rd, Emmett, ID 83617 | 2019-02-20 |
| 1598229809 | Clearwater Canyon Pharmacy, LLC | Pharmacy | 13020 Us-12, Orofino, ID 83544 | 2019-01-31 |
| 1861999377 | Bi-mart Corporation | Pharmacy | 11347 W State Street, Star, ID 83669 | 2018-04-11 |
| 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.