Organization Active NPI

Kroger Co of Michigan

Doing business as Kroger Pharmacy #459

  • Community/Retail Pharmacy
  • Westland, MI
National Provider Identifier
1619498086
Registry record updated Jul 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
KROGER CO OF MICHIGAN
Doing business as
Kroger Pharmacy #459
Practice address
7350 N Middlebelt Rd
Westland, MI 48185-2502
Phone
(734) 793-1050
NPI assigned
Jul 6, 2017
Last updated
Jul 6, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2017

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

Authorized official

Name
Allison Bredestege
Title
Manager of Pharmacy Licensing
Phone
(513) 762-1019

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

7350 N Middlebelt Rd
Westland, MI 48185-2502

Mailing address

PO Box 842772
Boston, MA 02284-2772

Other names 1

  • Kroger Pharmacy #459 Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Kroger Co of Michigan106 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.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1499299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1499299200000",
    "number": "1619498086",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7350 N MIDDLEBELT RD",
            "city": "WESTLAND",
            "state": "MI",
            "postal_code": "481852502",
            "telephone_number": "734-793-1050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KROGER CO OF MICHIGAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-06",
        "last_updated": "2017-07-06",
        "status": "A",
        "authorized_official_last_name": "BREDESTEGE",
        "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": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kroger Pharmacy #459",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Kroger Pharmacy #459",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Westland, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2017; 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.