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THE KROGER CO NPI 1619992393


NPI Information

NPI: 1619992393
Provider Name: THE KROGER CO

Doing Business As: KROGER PHARMACY

Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

CLIA Number: 11D0983365

Address:
3050 FIVE FORKS TRICKUM RD SW
LILBURN, GA
ZIP 30047
Phone: (770) 985-3720
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THE KROGER CO is a community/retail pharmacy pharmacy in Lilburn, 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 1619992393. The provider is registered as an organization entity type.
The provider Is Doing Business As Kroger Pharmacy.

The provider's business location address is:

3050 FIVE FORKS TRICKUM RD SW
LILBURN, GA
ZIP 30047-810
Phone: (770) 985-3720
Fax: (770) 985-6744

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 11D0983365 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/13/2006 and was last updated on 5/16/2016.


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 Pharmacy7399GEORGIAYes

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
100508263AMEDICAIDGEORGIA
22018065OTHERPK
30302060260MEDICARE NSC
4FLU346MEDICARE PIN
5P00003265MEDICARE PIN

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.