Kmart
Organization Active NPI Point of Service · Ironwood, MI
NPI 1124456884 · NPPES record last updated Oct 16, 2013
Key facts
- NPI
- 1124456884
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Point of Service 305S00000X
- License
- 530241688 (MI)
- Legal business name
- KMART
- Practice address
- 613 First National St
Ironwood, MI 49938-3329 - Phone
- (240) 994-3121
- NPI assigned
- Oct 16, 2013
- Organization subpart
- No
Authorized official
- Name
- Dr. Kelechi A Aguwa, PHARMD
- Title
- Pharmacy Manager
- Phone
- (240) 994-3121
Corporate family (same tax ID) 13
National Provider Directory
- Tax ID family
- Community Care Services
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Point of Service | 305S00000X | 530241688 | MI | Yes |
Addresses
Primary practice location
613 First National St
Ironwood, MI 49938-3329
Mailing address
613 First National St
Ironwood, MI 49938-3329
Phone (240) 994-3121
Other names
- Kmart Pharmacy
Other providers in Ironwood, MI
- Iron Mountain Vamc
- Louis James
- John Jarocki
- Brenda A Jaworski
- Kathleen D Kirchner
- Eve J. Komosa
- Ashley Koski
- Kevin Alden Kummerow
- Kelsey Ladwig
- Alyssa Bryanne Lamaide
All providers in Ironwood, MI · Point of Service in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 16, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.