KMART NPI 1124456884

NPI Information

  • NPI: 1124456884
  • Provider Name: KMART
  • Classification: Point of Service - 305S00000X
  • Entity Type: Organization
  • Other Name: KMART PHARMACY
  • Address: 613 FIRST NATIONAL ST
    IRONWOOD, MI
    ZIP 49938
  • Phone: (240) 994-3121

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NPI Details

KMART is a point of service in Ironwood, MI. The provider is this product may also be called an open-ended HMO and offers a transition product incorporating features of both HMOs and PPOs. Beneficiaries are enrolled in an HMO but have the option to go outside the networks for an additional cost. KMART NPI is 1124456884. The provider is registered as an organization entity type.
The provider Other Name Is Kmart Pharmacy.

The provider's business location address is:

613 FIRST NATIONAL ST
IRONWOOD, MI
ZIP 49938-329
Phone: (240) 994-3121

The provider's authorized official is Kelechi A Aguwa .
The authorized official title is Pharmacy Manager and has the following contact phone number (240) 994-3121.

The enumeration date for this NPI number is 10/16/2013 and was last updated on 10/16/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1305S00000XPoint of Service530241688MICHIGANYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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