K Mart Pharmacy #9354

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

26023951A Issued in IN

Legal business name

K MART PHARMACY #9354

Practice address

430 W Ridge Rd
Griffith, IN 46319-1018

Phone

(219) 972-0364

Fax

(847) 396-3229

NPI assigned

Mar 29, 2016

Organization subpart

No

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

Authorized official

Name

William Trzaskus, RPH

Title

Pharmacist

Phone

(219) 972-0364

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1459209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459209600000",
    "number": "1851754873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 W RIDGE RD",
            "city": "GRIFFITH",
            "state": "IN",
            "postal_code": "463191018",
            "telephone_number": "219-972-0364",
            "fax_number": "847-396-3229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 W RIDGE RD",
            "city": "GRIFFITH",
            "state": "IN",
            "postal_code": "463191018",
            "telephone_number": "219-972-0364",
            "fax_number": "847-396-3229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "K MART PHARMACY #9354",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-29",
        "last_updated": "2016-03-29",
        "status": "A",
        "authorized_official_last_name": "TRZASKUS",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "219-972-0364",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IN",
            "license": "26023951A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Infinity Transportaton
• Shaunta L Jamerson, RBT
• Allison Jernigan, RBT
• Angel Lynnett Johnson, MSW, LCSW
• Bruce Jones
• Susan Kaptur, RPH
• Hirut Manmektot Kassa
• Megan Michele Keel, DDS
• Pamela Kinley, RBT
• Faye Marie Kostidis

• Community/Retail Pharmacy in Griffith, IN
• Providers in Griffith, IN by specialty
• Community/Retail Pharmacy in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2016; 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.