NPIMap

Organization Active NPI

Kmart

  • Point of Service
  • Ironwood, MI
National Provider Identifier
1124456884
Registry record updated Oct 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Point of ServiceTaxonomy code 305S00000X
License
530241688 Issued in MI
Legal business name
KMART
Practice address
613 First National St
Ironwood, MI 49938-3329
Phone
(240) 994-3121
NPI assigned
Oct 16, 2013
Last updated
Oct 16, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2013

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

Authorized official

Name
Dr. Kelechi A Aguwa, PHARMDNPI 1083188841
Title
Pharmacy Manager
Phone
(240) 994-3121

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Point of Service 305S00000X 530241688 MI Primary

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 1

  • Kmart Pharmacy Other name

National Provider Directory

National Provider Directory
Tax ID family
Az Trans456 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 13

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 13

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1381881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1381881600000",
    "number": "1124456884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "613 FIRST NATIONAL ST",
            "city": "IRONWOOD",
            "state": "MI",
            "postal_code": "499383329",
            "telephone_number": "240-994-3121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "613 FIRST NATIONAL ST",
            "city": "IRONWOOD",
            "state": "MI",
            "postal_code": "499383329",
            "telephone_number": "240-994-3121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KMART",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-16",
        "last_updated": "2013-10-16",
        "status": "A",
        "authorized_official_last_name": "AGUWA",
        "authorized_official_first_name": "KELECHI",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "240-994-3121",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "MI",
            "license": "530241688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kmart Pharmacy",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Ironwood, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2013; 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.