Kmart Pharmacy

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

03132213 Issued in OH

Legal business name

KMART PHARMACY

Practice address

1284 Brice Rd
Reynoldsburg, OH 43068-2311

Phone

(614) 864-3636

NPI assigned

Jun 4, 2014

Organization subpart

No

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

Authorized official

Name

Craig Clemens

Title

Pharmacy Distrcit Manager

Phone

(330) 544-3086

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1401840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401840000000",
    "number": "1386057677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1284 BRICE RD",
            "city": "REYNOLDSBURG",
            "state": "OH",
            "postal_code": "430682311",
            "telephone_number": "614-864-3636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1284 BRICE RD",
            "city": "REYNOLDSBURG",
            "state": "OH",
            "postal_code": "430682311",
            "telephone_number": "614-864-3636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KMART PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-04",
        "last_updated": "2014-06-04",
        "status": "A",
        "authorized_official_last_name": "CLEMENS",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_title_or_position": "PHARMACY DISTRCIT MANAGER",
        "authorized_official_telephone_number": "330-544-3086"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OH",
            "license": "03132213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Des'Za'Rae King, LPCC
• Kirby E. Poling, DDS
• Ryan William Kirkpatrick, H.I.S.
• Austin Kiser
• Jeanette K Kathleen Klopfenstein
• Anshuli Koduri
• John Charles Kohl, DC
• Thomas S Kolberg, FNP
• Koolkidspirtion Mentor Ship Program
• Pramita Kothakota, MD

• Community/Retail Pharmacy in Reynoldsburg, OH
• Providers in Reynoldsburg, OH by specialty
• Community/Retail Pharmacy in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 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.