Kmart

NPI #1275734972 in Pembroke Pines, Florida

Provider Information

NPI Number: 1275734972
Entity Type: Organization
Organization Name: Kmart
Primary Specialty: Pharmacist
Enumeration Date: May 30, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: 10501 PINES BLVD
City: Pembroke Pines
State: Florida
ZIP Code: 33026
Phone: (954) 438-8822

Authorized Official

Name: MR. HENRY DAVID BRYANT, PHARMD
Title: PHARMACY INTERN
Phone: (954) 438-0705

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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