NPIMap

Organization Active NPI

Kroger

  • Community/Retail Pharmacy
  • Raleigh, NC
National Provider Identifier
1174937874
Registry record updated Jun 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
22678 Issued in NC
Legal business name
KROGER
Practice address
350 E Six Forks Rd
Raleigh, NC 27609-7879
Phone
(919) 838-2794
NPI assigned
Jun 20, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2014

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

Authorized official

Name
Sarah Bumgardner Snotherly
Title
Pharmd
Phone
(919) 624-6553

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 22678 NC Primary

Addresses

Primary practice location

350 E Six Forks Rd
Raleigh, NC 27609-7879

Mailing address

350 E Six Forks Rd
Raleigh, NC 27609-7879
Phone (919) 838-2794

Other identifiers 1

IdentifierTypeStateIssuer
0326495MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Krogerthe Kroger Pharmac611 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 2

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

NPI Registry JSON

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

{
    "created_epoch": "1403222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403222400000",
    "number": "1174937874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 E SIX FORKS RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276097879",
            "telephone_number": "919-838-2794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 E SIX FORKS RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276097879",
            "telephone_number": "919-838-2794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KROGER",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-20",
        "last_updated": "2014-06-20",
        "status": "A",
        "authorized_official_last_name": "SNOTHERLY",
        "authorized_official_first_name": "SARAH",
        "authorized_official_middle_name": "BUMGARDNER",
        "authorized_official_title_or_position": "PHARMD",
        "authorized_official_telephone_number": "919-624-6553"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NC",
            "license": "22678",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0326495",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.