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KROGER CO OF MICHIGAN NPI 1669406419


NPI Information

NPI: 1669406419
Provider Name: KROGER CO OF MICHIGAN

Doing Business As: KROGER PHARMACY

Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

CLIA Number: 23D2027767

Address:
7000 MONROE BLVD
TAYLOR, MI
ZIP 48180
Phone: (313) 299-1943
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KROGER CO OF MICHIGAN is a community/retail pharmacy pharmacy in Taylor, MI. The provider is a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. KROGER CO OF MICHIGAN NPI is 1669406419. The provider is registered as an organization entity type.
The provider Is Doing Business As Kroger Pharmacy.

The provider's business location address is:

7000 MONROE BLVD
TAYLOR, MI
ZIP 48180-883
Phone: (313) 299-1943
Fax: (313) 299-8579

The provider's authorized official is Jessie Warman .
The authorized official title is Manager Rx Licensing and has the following contact phone number (513) 762-1090.

The CLIA number assigned to this NPI record is 23D2027767 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/10/2006 and was last updated on 1/25/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1332B00000XDurable Medical Equipment & Medical SuppliesNo
2333600000XPharmacyNo
33336C0003XPharmacyCommunity/Retail Pharmacy5301007042MICHIGANYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
12044490OTHERPK
24113924MEDICAIDMICHIGAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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