THE KROGER CO (NPI# 1043673650) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043673650 |
| Entity Type | Organization |
| Organization Name | THE KROGER CO |
| Other Organization Name | KROGER PHARMACY #672 |
| Practice Address |
800 Glenwood Ave Se Atlanta GA 30316 |
| Mailing Address |
Po Box 842772 Boston MA 02284-2772 |
| Practice Telephone | 4704475040 |
| Practice Fax Number | 4704475023 |
| Mailing Telephone | 5137621019 |
| Enumeration Date | 2016-03-31 |
| Last Update Date | 2018-07-20 |
| Authorized Official Name | JESSIE WARMAN (MANAGER OF PHARMACY LICENSING) |
| Authorized Official Telephone | 5137621263 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
PHRE010295 | GA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2159227 | 01 | |
| GA | 003177043A | 05 |
| Other Name | Type Code |
|---|---|
| Kroger Pharmacy #672 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992325567 | The Kroger Co | Pharmacy | 3255 Eden Ave, Suite 336, Cincinnati, OH 45229 | 2020-04-23 |
| 1063073047 | The Kroger Co | Durable Medical Equipment & Medical Supplies | 725 Ponce De Leon Ave Ne, Atlanta, GA 30306-4329 | 2019-06-21 |
| 1922566017 | The Kroger Co | Durable Medical Equipment & Medical Supplies | 27 Discovery Dr, Bluffton, SC 22901 | 2019-03-07 |
| 1699272765 | The Kroger Co | Durable Medical Equipment & Medical Supplies | 5550 Bethelview Rd, Cumming, GA 30040 | 2018-04-06 |
| 1780134403 | The Kroger Co | Durable Medical Equipment & Medical Supplies | 2452 Morosgo Way Ne, Atlanta, GA 30324 | 2016-10-05 |
| 1730634239 | The Kroger Co | Durable Medical Equipment & Medical Supplies | 125 E Main St Se, Cartersville, GA 30121 | 2016-08-25 |
| 1548611288 | The Kroger Co | Durable Medical Equipment & Medical Supplies | 9484 Ellerbe Rd Ste 100, Shreveport, LA 71106 | 2016-06-23 |
| 1710335443 | The Kroger Co | Durable Medical Equipment & Medical Supplies | 435 Lewiston Rd, Grovetown, GA 30813 | 2016-06-03 |
| 1003262809 | The Kroger Co | Durable Medical Equipment & Medical Supplies | 1028 Roberts Branch Pkwy, Columbia, SC 29203 | 2016-05-11 |
| 1306202890 | The Kroger Co | Durable Medical Equipment & Medical Supplies | 461 S Columbia Ave, Rincon, GA 31326 | 2016-01-13 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | THE KROGER CO ZERO HUNGER ZERO WASTE FOUNDATION | 1014 Vine Street, Cincinnati, OH 45202 |
| Connecticut Business Registrations | The Kroger Co. | 1014 Vine Street, Cincinnati, OH 45202 |
| Oregon Corporations, Companies and Business Names | THE KROGER CO. | 1014 Vine St, Cincinnati, OH 45202 |
| Washington State Corporations | THE KROGER CO. | 1014 Vine St, Cincinnati, OH 45202-1141 |
| Virginia Business Entities | THE KROGER CO. | 1014 Vine Street, Cincinnati, Ohio 45202-1100 |
| Colorado Business Entities | THE KROGER CO. | 1014 Vine St, Cincinnati, OH 45202-1100 |
| Oklahoma Business Registrations | THE KROGER CO. | Attn: Tax Dept, 1014 Vine, Cincinnati, OH 45202-1100 |
| Oregon Corporations, Companies and Business Names | THE KROGER CO. FOUNDATION | 1014 Vine St, Cincinnati, OH 45202 |
| Washington State Corporations | THE KROGER CO. FOUNDATION | 1014 Vine St, Cincinnati, OH 45202-1141 |
| Colorado Business Entities | The Kroger Co. Foundation | 1014 Vine St, Cincinnati, OH 45202 |
| Street Address |
800 GLENWOOD AVE SE |
| City | ATLANTA |
| State | GA |
| Zip Code | 30316 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295358356 | Richard Andrew Blake | Pharmacist | 800 Glenwood Ave Se, Atlanta, GA 30316-1814 | 2020-05-24 |
| 1679192843 | Eunice Wang | Pharmacist | 800 Glenwood Ave Se, Atlanta, GA 30316-1814 | 2020-04-08 |
| 1235762477 | Jill Gilbert | Pharmacist | 800 Glenwood Ave Se, Atlanta, GA 30316-1814 | 2020-02-17 |
| 1497308506 | Tsitsi Muhoma | Nurse Practitioner | 800 Glenwood Ave Se, Atlanta, GA 30316-1814 | 2019-07-17 |
| 1679133771 | Sharde' Parkman | Nurse Practitioner | 800 Glenwood Ave Se, Atlanta, GA 30316-1814 | 2019-06-19 |
| 1467980623 | Kimberly Johnson | Student in an Organized Health Care Education/Training Program | 800 Glenwood Ave Se, Atlanta, GA 30316-1814 | 2017-05-31 |
| 1205385119 | Tlc of Georgia LLC | Nurse Practitioner | 800 Glenwood Ave Se, Atlanta, GA 30316-1814 | 2016-10-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073156923 | Rakiya Williams | Counselor | 1030 Fayetteville Rd., Atlanta, GA 30316 | 2019-10-23 |
| 1215585815 | Madison Victoria Baugh | Counselor | Chris180, 1030 Fayetteville Rd, Atlanta, GA 30316 | 2019-08-28 |
| 1265089460 | Josee Dominque Muldrew | Counselor | 1030 Fayetteville Rd. Se, Atlanta, GA 30316 | 2019-08-22 |
| 1255984241 | Monique Overstreet | Counselor | 1030 Fayetteville Road, Atlanta, GA 30316 | 2019-07-19 |
| 1023573979 | Publix Super Markets, Inc. | Durable Medical Equipment & Medical Supplies | 905 Memorial Drive Se, Atlanta-fulton, GA 30316 | 2019-02-05 |
| 1740726454 | Jimmy Brian Sambula | Behavior Technician | 1017 Fayetteville Rd. Se, Atlanta, GA 30316 | 2017-01-19 |
| 1033665039 | Liberty Group Senior Services | Clinic/Center | 1879 Glenwood Avenue, Atlanta, GA 30316 | 2016-08-30 |
| 1992143382 | Ayodele Osasona | Surgery | 2004 Oak Terrace Dr Se, Atlanta, GA 30316 | 2013-06-07 |
| 1891945721 | Denise Renee Cagle | Social Worker | 1471 Town Country Dr Se, Atlanta, GA 30316 | 2008-09-28 |
| 1235172388 | Bethanne Jenks | Pediatrics | 2006 Hosea Williams Dr, Atlanta, GA 30316 | 2006-06-14 |
| Find all providers in zip 30316 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| 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. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043817208 | Mlk Pharmacy2.0 | Pharmacy | 2457 Mlk Jr Dr Sw Ste A, Atlanta, GA 30311-1712 | 2020-10-01 |
| 1407492119 | Capsule Atlanta LLC | Pharmacy | 867 Peachtree St Ne Ste 102, Atlanta, GA 30308-1380 | 2019-11-18 |
| 1861978793 | Uhs of Peachford Lp | Pharmacy | 2150 Peachford Rd Ste D, Atlanta, GA 30338 | 2018-07-13 |
| 1497262778 | Champions Pharmacy | Pharmacy | 3886 Princeton Lakes Way Suite 180, Atlanta, GA 30331 | 2018-01-08 |
| 1912357641 | Headland Pharmacy LLC | Pharmacy | 2973 Headland Drive, Suite B, Atlanta, GA 30331 | 2016-06-14 |
| 1285022277 | Express Food & Pharmacy Investment LLC | Pharmacy | 2111 Campbellton Rd Sw, Atlanta, GA 30311-4605 | 2014-12-30 |
| 1881024479 | Camp Creek Village Pharmacy Inc. | Pharmacy | 3220 Butner Rd Sw Suite #130, Atlanta, GA 30331 | 2013-11-18 |
| 1487093662 | Pharm Holdings | Pharmacy | 102 E Allday St, Atlanta, TX 75551-2305 | 2013-06-20 |
| 1255676326 | Eastlake Pharmacy Inc | Pharmacy | 1308 Glenwood Ave Se, Atlanta, GA 30316-2077 | 2012-11-30 |
| 1689918468 | Wal-mart Stores East Lp | Pharmacy | 835 Martin Luther King Jr Dr Nw, Atlanta, GA 30314-3644 | 2012-11-19 |
| Find all providers in ATLANTA | ||||
Please comment or provide details below to improve the information on THE KROGER CO.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.