Kmart

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

RP0008667 Issued in WV

Legal business name

KMART

Practice address

6531 Maccorkle Ave SE
Charleston, WV 25304-2921

Phone

(304) 925-4721

NPI assigned

Sep 22, 2014

Organization subpart

No

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

Authorized official

Name

Andrew Scott

Title

Pharmacist

Phone

(304) 588-3553

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1411344000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411344000000",
    "number": "1992107874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6531 MACCORKLE AVE SE",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253042921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6531 MACCORKLE AVE SE",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253042921",
            "telephone_number": "304-925-4721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KMART",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-22",
        "last_updated": "2014-09-22",
        "status": "A",
        "authorized_official_last_name": "SCOTT",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "304-588-3553"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WV",
            "license": "RP0008667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaiden Klein
• Marcia Klein
• Robert Kline
• Brittany Mack Klinestiver
• Paul William Kloostra, MD, DDS
• Amber Knapp
• Jennifer Knapp
• Ross Joseph Knaub, DO
• Richard A Knebel, D.O.
• Talia Kniceley

• Community/Retail Pharmacy in Charleston, WV
• Providers in Charleston, WV by specialty
• Community/Retail Pharmacy in West Virginia

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