NPIMap

Organization Active NPI

Kmart

Doing business as Sears Holdings

  • Pharmacist
  • Pembroke Pines, FL
National Provider Identifier
1275734972
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
16466 Issued in FL
Legal business name
KMART
Doing business as
Sears Holdings
Practice address
10501 Pines Blvd
Pembroke Pines, FL 33026
Phone
(954) 438-8822
NPI assigned
May 30, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Henry David Bryant, PHARMDNPI 1629351192
Title
Pharmacy Intern
Phone
(954) 438-0705

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
PharmacistGroup: 193400000X SINGLE SPECIALTY GROUP 183500000X 16466 FL Primary

Addresses

Primary practice location

10501 Pines Blvd
Pembroke Pines, FL 33026

Mailing address

10020 Sheridan St
8309
Pembroke Pines, FL 33024-8555
Phone (954) 443-1028

Other names 1

  • Sears Holdings Doing business as

National Provider Directory

National Provider Directory

Locations

10501 Pines Blvd
Pembroke Pines, FL 33026
Phone (954) 438-0705

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": "1180483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1275734972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10020 SHERIDAN ST",
            "address_2": "8309",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330248555",
            "telephone_number": "954-443-1028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10501 PINES BLVD",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "33026",
            "telephone_number": "954-438-8822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KMART",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BRYANT",
        "authorized_official_first_name": "HENRY",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "PHARMACY INTERN",
        "authorized_official_telephone_number": "954-438-0705",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "16466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sears Holdings",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pembroke Pines, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.