Kmart Phramacy

Primary specialty

Point of ServiceTaxonomy code 305S00000X

License

0013355 Issued in CO

Legal business name

KMART PHRAMACY

Practice address

3415 N Elizabeth St
Pueblo, CO 81008-1156

Phone

(719) 545-0707

Fax

(847) 396-2896

NPI assigned

Apr 5, 2016

Organization subpart

No

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

Authorized official

Name

Mr. Seyed Abotaleb Alavi, RPH

Title

Pharmacist

Phone

(719) 568-0470

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1459814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459814400000",
    "number": "1891159976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 S GOLFWOOD DR W",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810073674",
            "telephone_number": "719-568-0470",
            "fax_number": "847-369-2896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3415 N ELIZABETH ST",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810081156",
            "telephone_number": "719-545-0707",
            "fax_number": "847-396-2896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KMART PHRAMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-05",
        "last_updated": "2016-04-05",
        "status": "A",
        "authorized_official_last_name": "ALAVI",
        "authorized_official_first_name": "SEYED",
        "authorized_official_middle_name": "ABOTALEB",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "719-568-0470",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "CO",
            "license": "0013355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nathan Klein, CRNA
• Molly S. Kliewer, FNP-BC, PMHNP-BC
• Jennifer Noel Klipfel, LMT,CLDT
• Macayla D Klipfel
• Raeven Irina Klipple
• KMD Therapy Associates, LLC
• Megan Knaus
• Kerri J Knight, RBT
• Debbie Mae Knish, LPN
• Lara Kjurston Knowles, CRNA

• Point of Service in Pueblo, CO
• Providers in Pueblo, CO by specialty
• Point of Service in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 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.