KMART OF MICHIGAN INC (NPI# 1982635975) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982635975 |
| Entity Type | Organization |
| Organization Name | KMART OF MICHIGAN INC |
| Other Organization Name | KMART PHARMACY3864 |
| Practice Address |
2110 S M 76 West Branch MI 48661-8737 |
| Mailing Address |
3333 Beverly Rd Ac 367 B Hoffman Estates IL 60179-0001 |
| Practice Telephone | 9893454884 |
| Practice Fax Number | 9893454095 |
| 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 |
5301005457 | MI | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2041060 | 01 | |
| MI | 2689386 | 05 |
| Other Name | Type Code |
|---|---|
| KMART PHARMACY3864 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114353919 | Kmart of Michigan Inc | Pharmacy | 2425 S I 75 Business Loop, Grayling, MI 49738-2042 | 2013-09-25 |
| 1609984095 | Kmart of Michigan Inc | Pharmacy | 1151 S Otsego Ave # A, Gaylord, MI 49735-1789 | 2006-08-27 |
| 1760413751 | Kmart of Michigan Inc | Pharmacy | 2500 E M21, Corunna, MI 48817 | 2006-07-06 |
| 1700817780 | Kmart of Michigan Inc | Pharmacy | 19800 West Rd, Woodhaven, MI 48183-3319 | 2006-07-06 |
| 1609807692 | Kmart of Michigan Inc | Pharmacy | 6730 River Rd, Marine City, MI 48039-2284 | 2006-07-06 |
| 1538190517 | Kmart of Michigan Inc | Pharmacy | 100 E Maple Rd, Troy, MI 48083-2714 | 2006-07-06 |
| 1457382434 | Kmart of Michigan Inc | Pharmacy | 215 N Maple Rd, Ann Arbor, MI 48103-2823 | 2006-07-06 |
| 1538190525 | Kmart of Michigan Inc | Pharmacy | 710 Chicago Dr, Holland, MI 49423-3074 | 2006-07-06 |
| 1750312740 | Kmart of Michigan Inc | Pharmacy | 17580 Frazho Rd, Roseville, MI 48066-3829 | 2006-07-06 |
| 1336170323 | Kmart of Michigan Inc | Pharmacy | 2948 S State Rd, Ionia, MI 48846-9475 | 2006-07-06 |
| Street Address |
2110 S M 76 |
| City | WEST BRANCH |
| State | MI |
| Zip Code | 48661-8737 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740502012 | Phillip James Rembelski | Pharmacist | 2110 S M 76, West Branch, MI 48661-8737 | 2010-02-26 |
| 1033732391 | Mclaren Central Michigan | Clinic/Center | 2110 S M 76, West Branch, MI 48661-8737 | 2020-05-21 |
| 1811344153 | Brian James Bennett | Pharmacist | 2110 S M 76, West Branch, MI 48661-8737 | 2016-05-17 |
| 1790148492 | Kmart Pharmacy | Pharmacy | 2110 S M 76, West Branch, MI 48661-8737 | 2016-03-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992226773 | Linda Loou Thopmson | Registered Nurse | 335 E. Houghton Ave., West Branch, MI 48661 | 2017-06-30 |
| 1831559103 | Lisa J. Gutierrez | Counselor | 105 N. 3rd St., Ste 6, West Branch, MI 48661 | 2016-03-01 |
| 1497185383 | Linda Joy Latulip | Social Worker | 445 S. Valley, West Branch, MI 48661 | 2013-11-14 |
| 1376973289 | Patricia Woelke | Occupational Therapist | 335 East Houghton, West Branch, MI 48661 | 2013-11-14 |
| 1760731012 | Lucas John Wyzlic | Physician Assistant | 621 Court Street, Suite 104, West Branch, MI 48661 | 2012-08-31 |
| 1225312234 | Mark Bedtelyon | Pharmacist | 2480 E Houghton Ave, West Branch, MI 48661 | 2011-10-10 |
| 1790016632 | Stephanie M Witte-mason | Chiropractor | 2333 S M 76, West Branch, MI 48661 | 2010-01-15 |
| 1578798997 | Michael Robert Munger | Dietitian, Registered | 2897 Amanda Ct., West Branch, MI 48661 | 2009-05-29 |
| 1124261516 | Sarah C. Bryce | Pharmacist | 501 E. Houghton Ave, West Branch, MI 48661 | 2009-04-14 |
| 1528208303 | Richard K Braidwood | Pharmacist | 2206 S. M-76, West Branch, MI 48661 | 2009-03-06 |
| Find all providers in zip 48661 | ||||
| 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 |
|---|---|---|---|---|
| 1609857523 | Pioneer Family Pharmacy Inc | Pharmacy | 2206 S M 76, West Branch, MI 48661-9343 | 2005-11-08 |
| 1194354035 | Midmichigan Medical Center- West Branch | Pharmacy | 2463 S M 30, West Branch, MI 48661-9312 | 2020-04-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609477389 | Rose Rex LLC | Pharmacy | 2330 S Milford Rd Ste 114, Highland, MI 48357-4982 | 2020-11-08 |
| 1508466194 | Grand Gratiot Pharmacy, LLC | Pharmacy | 7011 Gratiot Ave Ste 100, Detroit, MI 48207-1973 | 2020-10-31 |
| 1104424530 | Advance Care Rx, LLC | Pharmacy | 500 N Cass St, Berrien Springs, MI 49103-1069 | 2020-10-16 |
| 1023616554 | Henry Ford Health System | Pharmacy | 2800 W Grand Blvd, Detroit, MI 48208 | 2020-10-16 |
| 1881292001 | Healthwatch Pharmacy Inc | Pharmacy | 1375 S Lapeer Rd Ste 102, Lake Orion, MI 48360-1421 | 2020-10-09 |
| 1225645781 | Good Choice Pharmacy LLC | Pharmacy | 6750 E 10 Mile Rd, Center Line, MI 48015-1166 | 2020-09-29 |
| 1487269122 | Canfield Pharmacy LLC | Pharmacy | 4673 Conner St, Detroit, MI 48215-2028 | 2020-09-10 |
| 1851905707 | Skidway Pharmacy LLC | Pharmacy | 1830 Greenwood Rd, Prescott, MI 48756-8627 | 2020-09-08 |
| 1023621190 | Azam Mohsen Mesleh | Pharmacy | 6811 Theisen St, Dearborn, MI 48126-1927 | 2020-08-28 |
| 1821606310 | S&k Pharmacy Inc. | Pharmacy | 1916 Davison Rd, Flint, MI 48506-4423 | 2020-07-21 |
| Find all providers with the same taxonomy | ||||
| City | WEST BRANCH |
| Zip Code | 48661 |
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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.