Kroger Pharmacy

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

021693 Issued in LA

Legal business name

KROGER PHARMACY

Practice address

6652 Youree Dr
Shreveport, LA 71105-4630

Phone

(318) 795-9966

NPI assigned

Oct 11, 2016

Organization subpart

Yes

Parent organization

KROGER COMPANYAs reported in NPPES

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

Authorized official

Name

Rhonny Valentine

Title

Pharmacist in Charge

Phone

(318) 795-9966

Specialties & licenses 1

Addresses

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

CLIA laboratory certificates

Tax ID family

Kroger Pharmacy 777201 organizations share this tax ID, including this one

Part of

Kroger Pharmacy 253

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

{
    "created_epoch": "1476144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476144000000",
    "number": "1598215840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 ISLAND PARK BLVD",
            "address_2": "714",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711054741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6652 YOUREE DR",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711054630",
            "telephone_number": "318-795-9966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KROGER PHARMACY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KROGER COMPANY",
        "enumeration_date": "2016-10-11",
        "last_updated": "2016-10-11",
        "status": "A",
        "authorized_official_last_name": "VALENTINE",
        "authorized_official_first_name": "RHONNY",
        "authorized_official_title_or_position": "PHARMACIST IN CHARGE",
        "authorized_official_telephone_number": "318-795-9966"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "LA",
            "license": "021693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Krishna R. Singh MD Apmc
• Prathik Krishnan, M.D.
• Kristi Michael MD and Willis Knighton Medical Center
• Kristy Braud, MD and Willis-Knighton Medical Center
• Kristy Waltman MD and Willis-Knighton Medical Center
• Richard William Krouskop, M.D.
• KRS Rides LLC
• Beverly Kruise, REGISTERED NURSE
• Estrelita Ong Ku, M.D.
• Shreedhar Kulkarni, M.D.

• Community/Retail Pharmacy in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Community/Retail Pharmacy in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.