The Kroger Co

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

8545 Issued in GA

Legal business name

THE KROGER CO

Practice address

10375 Tara Blvd
Jonesboro, GA 30236-6536

Phone

(770) 477-0975

Fax

(770) 603-6487

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
  • Decatur, GA
  • NPI 1376577189
  NPD tax ID
• The Kroger Co

  • Community/Retail Pharmacy
  • Loganville, GA
  • NPI 1386678126
  NPD tax ID
• The Kroger Co

  • Community/Retail Pharmacy
  • Union City, GA
  • NPI 1386678266
  NPD tax ID
• The Kroger Co

  • Community/Retail Pharmacy
  • Lagrange, GA
  • NPI 1407880230
  NPD tax ID
• The Kroger Co

  • Community/Retail Pharmacy
  • Newnan, GA
  • NPI 1417981119
  NPD tax ID
• The Kroger Co

  • Community/Retail Pharmacy
  • Duluth, GA
  • NPI 1417981226
  NPD tax ID
• The Kroger Co

  • Community/Retail Pharmacy
  • Marietta, GA
  • NPI 1427073105
  NPD tax ID
• The Kroger Co

  • Community/Retail Pharmacy
  • Evans, GA
  • NPI 1427082254
  NPD tax ID
• The Kroger Co

  • Community/Retail Pharmacy
  • Woodstock, GA
  • NPI 1437174117
  NPD tax ID
• The Kroger Co

  • Community/Retail Pharmacy
  • Woodstock, GA
  • NPI 1437183241
  NPD tax ID
• The Kroger Co

  • Community/Retail Pharmacy
  • Oakwood, GA
  • NPI 1447186929
  NPD tax ID
• The Kroger Co

  • Community/Retail Pharmacy
  • Marietta, GA
  • NPI 1457376139
  NPD tax ID

Locations

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": "1457385262",
    "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": "10375 TARA BLVD",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302366536",
            "telephone_number": "770-477-0975",
            "fax_number": "770-603-6487"
        }
    ],
    "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": "8545",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2014421",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00653023B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KROGER PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Jonesboro, 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.