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Kmart — NPI 1124456884, Ironwood, MI | NPI Central

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NPI 1124456884

OrganizationActive

Kmart

NPI 1124456884 · Point of Service · Ironwood, MI

Provider details

NPI number: 1124456884
Entity type: Organization
Primary specialty: Point of ServiceManaged Care Organizations
Organization subpart: No
Authorized official: Kelechi Aguwa, Pharmacy Manager(240) 994-3121
License: 530241688 (MI)

Specialties & taxonomies

Point of ServicePrimary305S00000XLicense 530241688 (MI)
Managed Care Organizations

Practice location

613 First National St

Ironwood, MI 49938-3329

Phone: (240) 994-3121

Approximate (ZIP-level) locationGet directions

More MI providers

Mailing address

613 First National St

Ironwood, MI 49938-3329

Other names (DBA / former)

Other name: Kmart Pharmacy

Registry dates

Enumerated: 2013-10-16
Last updated: 2013-10-16

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.