NPIMap

Organization Active NPI

Kroger Pharmacy

  • Pharmacist
  • Fairborn, OH
National Provider Identifier
1740403401
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
03321850 Issued in OH
Legal business name
KROGER PHARMACY
Practice address
1161 E Dayton Yellow Springs Rd
Fairborn, OH 45324-6325
Phone
(937) 754-4427
Fax
(937) 754-4578
NPI assigned
Apr 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Roy Klass, RPH
Title
Pharmacy Manager
Phone
(937) 754-4427

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PharmacistGroup: 193200000X MULTI-SPECIALTY GROUP 183500000X 03321850 OH Primary

Addresses

Primary practice location

1161 E Dayton Yellow Springs Rd
Fairborn, OH 45324-6325

Mailing address

1161 E Dayton Yellow Springs Rd
Fairborn, OH 45324-6325
Phone (937) 754-4427

National Provider Directory

National Provider Directory
Tax ID family
Krogerthe Kroger Pharmac611 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": "1176249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1740403401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1161 E DAYTON YELLOW SPRINGS RD",
            "city": "FAIRBORN",
            "state": "OH",
            "postal_code": "453246325",
            "telephone_number": "937-754-4427",
            "fax_number": "937-754-4580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1161 E DAYTON YELLOW SPRINGS RD",
            "city": "FAIRBORN",
            "state": "OH",
            "postal_code": "453246325",
            "telephone_number": "937-754-4427",
            "fax_number": "937-754-4578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KROGER PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KLASS",
        "authorized_official_first_name": "ROY",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "937-754-4427",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pharmacist",
            "state": "OH",
            "license": "03321850",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairborn, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.