The Kroger Co

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

7893 Issued in GA

Legal business name

THE KROGER CO

Practice address

3651 Peachtree Pkwy
Suwanee, GA 30024-6034

Phone

(770) 418-2388

Fax

(770) 418-0767

NPI assigned

Jul 13, 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

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
  • Newnan, GA
  • NPI 1710040225
  NPD tax ID
• The Kroger Co

  • Community/Retail Pharmacy
  • Grovetown, GA
  • NPI 1710335443
  NPD tax ID
• The Kroger Co

  • Community/Retail Pharmacy
  • Woodstock, GA
  • NPI 1720012560
  NPD tax ID
• The Kroger Co

  • Community/Retail Pharmacy
  • Duluth, GA
  • NPI 1720012610
  NPD tax ID
• The Kroger Co

  • Community/Retail Pharmacy
  • Cumming, GA
  • NPI 1730104514
  NPD tax ID
• The Kroger Co

  • Community/Retail Pharmacy
  • Athens, GA
  • NPI 1730113549
  NPD tax ID
• The Kroger Co

  • Community/Retail Pharmacy
  • Cartersville, GA
  • NPI 1730634239
  NPD tax ID
• The Kroger Co

  • Community/Retail Pharmacy
  • Dalton, GA
  • NPI 1740214550
  NPD tax ID
• The Kroger Co

  • Community/Retail Pharmacy
  • Savannah, GA
  • NPI 1740214584
  NPD tax ID
• The Kroger Co

  • Community/Retail Pharmacy
  • Dalton, GA
  • NPI 1770517591
  NPD tax ID
• The Kroger Co

  • Community/Retail Pharmacy
  • Brookhaven, GA
  • NPI 1770517682
  NPD tax ID
• The Kroger Co

  • Community/Retail Pharmacy
  • Milledgeville, GA
  • NPI 1790067809
  NPD tax ID

Locations

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

• Tulika Bhushan Bahukhandi

  • Pharmacist
  • Suwanee, GA
  • NPI 1336748557
  NPD (past)
• Pooja Patel

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Suwanee, GA
  • NPI 1629676101
  NPD (past)
• Richard M Tomelevage, RPH

  • Ambulatory Care Pharmacist
  • Suwanee, GA
  • NPI 1952561904
  NPD (past)
• Marjan Zafar

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Suwanee, GA
  • NPI 1407455561
  NPD (past)

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

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463356800000",
    "number": "1790700474",
    "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": "3651 PEACHTREE PKWY",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300246034",
            "telephone_number": "770-418-2388",
            "fax_number": "770-418-0767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE KROGER CO",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-13",
        "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": "7893",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00665684A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2019152",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KROGER PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Suwanee, 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.