The Kroger Co

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

6385 Issued in GA

Legal business name

THE KROGER CO

Doing business as

KROGER PHARMACY

Practice address

4155 Highway 29 and Beaver Run
Lilburn, GA 30047

Phone

(770) 717-3044

Fax

(770) 717-0589

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 19

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
  • Waycross, GA
  • NPI 1902830748
  NPD tax ID
• The Kroger Co

  • Community/Retail Pharmacy
  • Savannah, GA
  • NPI 1902830896
  NPD tax ID
• The Kroger Co

  • Community/Retail Pharmacy
  • Jefferson, GA
  • NPI 1912028267
  NPD tax ID
• The Kroger Co

  • Community/Retail Pharmacy
  • Bonaire, GA
  • NPI 1912232927
  NPD tax ID
• The Kroger Co

  • Community/Retail Pharmacy
  • Locust Grove, GA
  • NPI 1912820655
  NPD tax ID
• The Kroger Co

  • Community/Retail Pharmacy
  • Roswell, GA
  • NPI 1912931726
  NPD tax ID
• The Kroger Co

  • Community/Retail Pharmacy
  • Marietta, GA
  • NPI 1922023704
  NPD tax ID
• The Kroger Co

  • Community/Retail Pharmacy
  • Atlanta, GA
  • NPI 1922032754
  NPD tax ID
• The Kroger Co

  • Community/Retail Pharmacy
  • Marietta, GA
  • NPI 1932124617
  NPD tax ID
• The Kroger Co

  • Community/Retail Pharmacy
  • Warner Robins, GA
  • NPI 1932393550
  NPD tax ID
• The Kroger Co

  • Community/Retail Pharmacy
  • Marietta, GA
  • NPI 1942234778
  NPD tax ID
• The Kroger Co

  • Community/Retail Pharmacy
  • Martinez, GA
  • NPI 1942234794
  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": "1463529600000",
    "number": "1952335770",
    "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": "4155 HIGHWAY 29 AND BEAVER RUN",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "30047",
            "telephone_number": "770-717-3044",
            "fax_number": "770-717-0589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE KROGER CO",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-10",
        "last_updated": "2016-05-18",
        "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": "6385",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00295457A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2014873",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KROGER PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Lilburn, GA
• Providers in Lilburn, GA by specialty
• Community/Retail Pharmacy in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 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.