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THE KROGER CO NPI 1043244890


NPI Information

NPI: 1043244890
Provider Name: THE KROGER CO

Doing Business As: KROGER PHARMACY #629

Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

CLIA Number: 11D0984217

Address:
125 E MAIN ST
CARTERSVILLE, GA
ZIP 30120
Phone: (770) 386-8160
Get Directions

THE KROGER CO is a community/retail pharmacy pharmacy in Cartersville, GA. 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. THE KROGER CO NPI is 1043244890. The provider is registered as an organization entity type.
The provider Is Doing Business As Kroger Pharmacy #629.

The provider's business location address is:

125 E MAIN ST
CARTERSVILLE, GA
ZIP 30120-317
Phone: (770) 386-8160
Fax: (770) 387-0694

The provider's authorized official is Allison Muennich .
The authorized official title is Manager Of Pharmacy Licensing and has the following contact phone number (513) 762-1019.

The CLIA number assigned to this NPI record is 11D0984217 - 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 10/6/2016.


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 Pharmacy5672GEORGIAYes

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
12014471OTHERPK
2FLU346MEDICARE PIN
3P00003265MEDICARE PIN
400207193AMEDICAIDGEORGIA
50302060229MEDICARE NSC

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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