# KMART PHARMACY

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1386057677
- **Authorized official:** CRAIG CLEMENS (PHARMACY DISTRCIT MANAGER)
- **Authorized official phone:** (330) 544-3086

## Contact information

- **Practice address:** 1284 BRICE RD, REYNOLDSBURG, OH 43068-2311
- **Practice address phone:** (614) 864-3636
- **Mailing address:** 1284 BRICE RD, REYNOLDSBURG, OH 43068-2311
- **Mailing address phone:** (614) 864-3636

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 03132213 | OH | Yes |

## Other

- **Enumeration date:** 06/04/2014
- **Last updated:** 06/04/2014