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KMART PHARMACY 3022
NPI 1912361619
Pharmacist in Bristol, TN

Active since April 08, 2016
2854 W STATE ST, BRISTOL, TN 37620(423) 968-7032(847) 396-2508 Get Directions Write a Review

NPPES record last updated: April 8, 2016. Verified against the NPPES registry weekly; last sync: October 04, 2026.

About Kmart Pharmacy 3022 NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KMART PHARMACY 3022 (NPI 1912361619) is a healthcare organization registered as a pharmacist in Bristol, Tennessee and active in the NPI registry since April 2016. The organization lists Charles Edwin Roberts, Pharmacist, as its authorized official.

NPPES Registry Identity

NPI1912361619
Entity TypeOrganization
Primary Taxonomy183500000X
Legal Business NameKMART PHARMACY 3022
Location Address2854 W STATE STBristol, TN 37620-1711
Mailing Address2854 W State StBristol, TN 37620-1711 · (423) 968-7032 · Fax (847) 396-2508
Phone(423) 968-7032
Fax(847) 396-2508
Organization SubpartNo
Authorized OfficialCharles Edwin RobertsPharmacist · (423) 968-7032
Enumeration DateApril 8, 2016
✔ NPI 1912361619 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPharmacistPharmacy Service Providers
Taxonomy Code183500000X
License✔ Licensed in TN · 36205
Definition
An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care.
2854 W STATE ST, Bristol, TN 37620
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. JAMES DENNIS GLASS DPH
Pharmacist
2854 W STATE ST
BRISTOL, TN 37620
Sullivan County (423) 968-7032

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kmart Pharmacy 3022's NPI number?

The NPI number for Kmart Pharmacy 3022 is 1912361619. It was assigned to this organization in the NPPES registry on April 8, 2016.

Where is Kmart Pharmacy 3022 located?

Kmart Pharmacy 3022 is located at 2854 W State St, Bristol, TN 37620. The listed phone number is (423) 968-7032.

What is Kmart Pharmacy 3022's specialty?

The primary specialty registered for this NPI is Pharmacist with taxonomy code 183500000X.

When was this NPI record last updated?

The NPPES record for Kmart Pharmacy 3022 was last updated on April 8, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.