The Kroger Co

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

7158 Issued in GA

Legal business name

THE KROGER CO

Practice address

2100 Riverside Pkwy
Lawrenceville, GA 30043-5927

Phone

(770) 962-1197

Fax

(770) 962-4581

NPI assigned

Jul 10, 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
  • McDonough, GA
  • NPI 1174557987
  NPD tax ID
• The Kroger Co

  • Community/Retail Pharmacy
  • Alpharetta, GA
  • NPI 1194740878
  NPD tax ID
• The Kroger Co

  • Community/Retail Pharmacy
  • Douglasville, GA
  • NPI 1194759076
  NPD tax ID
• The Kroger Co

  • Community/Retail Pharmacy
  • Jonesboro, GA
  • NPI 1215952098
  NPD tax ID
• The Kroger Co

  • Community/Retail Pharmacy
  • Atlanta, GA
  • NPI 1225062045
  NPD tax ID
• The Kroger Co

  • Community/Retail Pharmacy
  • Flowery Branch, GA
  • NPI 1245264050
  NPD tax ID
• The Kroger Co

  • Community/Retail Pharmacy
  • McDonough, GA
  • NPI 1255356937
  NPD tax ID
• The Kroger Co

  • Community/Retail Pharmacy
  • Powder Springs, GA
  • NPI 1255365060
  NPD tax ID
• The Kroger Co

  • Community/Retail Pharmacy
  • Dawsonville, GA
  • NPI 1265466007
  NPD tax ID
• The Kroger Co

  • Community/Retail Pharmacy
  • Savannah, GA
  • NPI 1265466072
  NPD tax ID
• The Kroger Co

  • Community/Retail Pharmacy
  • Savannah, GA
  • NPI 1265580880
  NPD tax ID
• The Kroger Co

  • Community/Retail Pharmacy
  • Athens, GA
  • NPI 1285659060
  NPD tax ID

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463356800000",
    "number": "1285668012",
    "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": "2100 RIVERSIDE PKWY",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300435927",
            "telephone_number": "770-962-1197",
            "fax_number": "770-962-4581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE KROGER CO",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-10",
        "last_updated": "2016-05-16",
        "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": "7158",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2017313",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00418426A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KROGER PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Community/Retail Pharmacy in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2016; 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.