The Kroger Co

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

6372 Issued in GA

Legal business name

THE KROGER CO

Practice address

4628 Presidential Pkwy
Macon, GA 31206-8708

Phone

(478) 405-3916

Fax

(478) 405-3918

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
  • Lawrenceville, GA
  • NPI 1285668012
  NPD tax ID
• The Kroger Co

  • Community/Retail Pharmacy
  • Kennesaw, GA
  • NPI 1285668020
  NPD tax ID
• The Kroger Co

  • Community/Retail Pharmacy
  • Marietta, GA
  • NPI 1285668095
  NPD tax ID
• The Kroger Co

  • Community/Retail Pharmacy
  • Rincon, GA
  • NPI 1306202890
  NPD tax ID
• The Kroger Co

  • Community/Retail Pharmacy
  • Douglasville, GA
  • NPI 1306861182
  NPD tax ID
• The Kroger Co

  • Community/Retail Pharmacy
  • Macon, GA
  • NPI 1306870134
  NPD tax ID
• The Kroger Co

  • Community/Retail Pharmacy
  • Marietta, GA
  • NPI 1316971138
  NPD tax ID
• The Kroger Co

  • Community/Retail Pharmacy
  • Acworth, GA
  • NPI 1316971146
  NPD tax ID
• The Kroger Co

  • Community/Retail Pharmacy
  • Stone Mountain, GA
  • NPI 1326072133
  NPD tax ID
• The Kroger Co

  • Community/Retail Pharmacy
  • Peachtree City, GA
  • NPI 1336164011
  NPD tax ID
• The Kroger Co

  • Community/Retail Pharmacy
  • Norcross, GA
  • NPI 1336173160
  NPD tax ID
• The Kroger Co

  • Community/Retail Pharmacy
  • Buford, GA
  • NPI 1346274156
  NPD tax ID

Locations

Practitioners 1

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

• Angela Travis Joslin

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Macon, GA
  • NPI 1326647116
  NPD (past)

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": "1356375166",
    "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": "4628 PRESIDENTIAL PKWY",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312068708",
            "telephone_number": "478-405-3916",
            "fax_number": "478-405-3918"
        }
    ],
    "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": "6372",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2014435",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00659227B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KROGER PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Macon, GA
• 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.