Kmart Pharmacy

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

RP00007752 Issued in NM

Legal business name

KMART PHARMACY

Practice address

1205 E Pine St
Deming, NM 88030-7038

Phone

(575) 544-9008

Fax

(575) 544-4465

NPI assigned

May 3, 2014

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Ambrish N Patel, PHARMD

Title

Pharmacy Manager

Phone

(405) 370-4669

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1399075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399075200000",
    "number": "1104236843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 E PINE ST",
            "city": "DEMING",
            "state": "NM",
            "postal_code": "880307038",
            "telephone_number": "575-544-9008",
            "fax_number": "575-544-4465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 E PINE ST",
            "city": "DEMING",
            "state": "NM",
            "postal_code": "880307038",
            "telephone_number": "575-544-9008",
            "fax_number": "575-544-4465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KMART PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-03",
        "last_updated": "2014-05-03",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "AMBRISH",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "405-370-4669",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NM",
            "license": "RP00007752",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY NPI NUMBER",
            "identifier": "1619908753",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karr Kare
• Codi Keeler
• Margaret Kemp, BSN, RN
• Myra M Kershaw
• Yulia Khan, MASSAGE THERAPIST
• Chester Kwong, SW
• La Fronter Center, Inc. Dba la Frontera New Mexico, Inc.
• George I Lafon, MD
• David P Lanoue, MD
• Amy Lawrence Simonds, CNP

• Community/Retail Pharmacy in Deming, NM
• Providers in Deming, NM by specialty
• Community/Retail Pharmacy in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.