Organization · Type 2 NPI
Kmart Phramacy
Point of Service · Pueblo, CO
NPI number
1891159976
Active
Practice location
3415 N Elizabeth St
Pueblo, CO 81008-1156
Fax (847) 396-2896
Mailing address
206 S Golfwood Dr W
Pueblo, CO 81007-3674
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Point of Service Primary | 305S00000X | 0013355 (CO) |
Point of Service: 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.
Another provider at this address
About NPI 1891159976
Kmart Phramacy's National Provider Identifier is 1891159976, issued on Apr 5, 2016. The primary taxonomy on file is Point of Service (305S00000X), and the practice location is in Pueblo, CO. The record was last updated on Apr 5, 2016.