The Kroger Co

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

8944 Issued in GA

Legal business name

THE KROGER CO

Practice address

457 Nathan Dean Blvd
Dallas, GA 30132-4911

Phone

(770) 443-8776

Fax

(770) 443-0653

NPI assigned

Jul 13, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Allison Muennich

Title

Manager of Pharmacy Licensing

Phone

(513) 762-1019

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• KROGER PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in GA2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Medicare medical equipment & supply locations

Tax ID family

Kroger Sav on J926319 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

• The Kroger Co

  • Community/Retail Pharmacy
  • Fayetteville, GA
  • NPI 1023033701
  NPD tax ID
• The Kroger Co

  • Community/Retail Pharmacy
  • Augusta, GA
  • NPI 1033143862
  NPD tax ID
• The Kroger Co

  • Community/Retail Pharmacy
  • Mableton, GA
  • NPI 1033143888
  NPD tax ID
• The Kroger Co

  • Community/Retail Pharmacy
  • Athens, GA
  • NPI 1043244866
  NPD tax ID
• The Kroger Co

  • Community/Retail Pharmacy
  • Cartersville, GA
  • NPI 1043244890
  NPD tax ID
• The Kroger Co

  • Community/Retail Pharmacy
  • Snellville, GA
  • NPI 1043244957
  NPD tax ID
• The Kroger Co

  • Community/Retail Pharmacy
  • Atlanta, GA
  • NPI 1043673650
  NPD tax ID
• The Kroger Co

  • Community/Retail Pharmacy
  • Atlanta, GA
  • NPI 1063073047
  NPD tax ID
• The Kroger Co

  • Community/Retail Pharmacy
  • Douglasville, GA
  • NPI 1063446870
  NPD tax ID
• The Kroger Co

  • Community/Retail Pharmacy
  • Macon, GA
  • NPI 1073538757
  NPD tax ID
• The Kroger Co

  • Community/Retail Pharmacy
  • Atlanta, GA
  • NPI 1083648893
  NPD tax ID
• The Kroger Co

  • Community/Retail Pharmacy
  • Sugar Hill, GA
  • NPI 1093029183
  NPD tax ID

Locations

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Katherine Ann Anderson

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Dallas, GA
  • NPI 1982203113
  NPD
• Mihir Changela

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Atlanta, GA
  • NPI 1144988684
  NPD
• Sarah Kell

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Dallas, GA
  • NPI 1982237384
  NPD
• Jeffrey Rakestraw

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Dallas, GA
  • NPI 1235760430
  NPD
• Amanueal Wodajo

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Dallas, GA
  • NPI 1952932600
  NPD
• Patrick Tu, PHARM.D

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Dallas, GA
  • NPI 1497176424
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745193600000",
    "number": "1093730871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 842772",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022842772",
            "telephone_number": "513-762-1019",
            "fax_number": "513-762-1092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "457 NATHAN DEAN BLVD",
            "city": "DALLAS",
            "state": "GA",
            "postal_code": "301324911",
            "telephone_number": "770-443-8776",
            "fax_number": "770-443-0653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE KROGER CO",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-13",
        "last_updated": "2025-04-21",
        "certification_date": "2025-04-21",
        "status": "A",
        "authorized_official_last_name": "MUENNICH",
        "authorized_official_first_name": "ALLISON",
        "authorized_official_title_or_position": "MANAGER OF PHARMACY LICENSING",
        "authorized_official_telephone_number": "513-762-1019"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "GA",
            "license": "8944",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2016092",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000352426C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KROGER PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Frank A Terracina Jr., DMD
• Cailee Terry
• Crystal Howard Terry, RBT
• The Conscious Spot LTD
• The Java Group LLC
• The Kroger Co
• The Northrop Connection, LLC
• The Pink Ribbon Mammography and Diagnostic Radiology Services LLC
• The Webb Raughton Counseling and Consulting Firm
• Therapeutic Connections

• All providers in Dallas, GA
• Community/Retail Pharmacy in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.