KROGER CO OF MICHIGAN (NPI# 1093749863) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093749863 |
| Entity Type | Organization |
| Organization Name | KROGER CO OF MICHIGAN |
| Other Organization Name | KROGER PHARMACY |
| Practice Address |
9741 Dixie Hwy Clarkston MI 48348-4145 |
| Mailing Address |
Po Box 842772 Boston MA 02284-2772 |
| Practice Telephone | 2489220468 |
| Practice Fax Number | 2489220838 |
| Mailing Telephone | 5137621019 |
| Mailing Fax Number | 5137621092 |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2019-01-25 |
| Authorized Official Name | JESSIE WARMAN (MANAGER RX LICENSING) |
| Authorized Official Telephone | 5137621090 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
5301007866 | MI | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2046680 | 01 | |
| MI | 2365725 | 05 |
| Other Name | Type Code |
|---|---|
| KROGER PHARMACY | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699395459 | Kroger Co of Michigan | Durable Medical Equipment & Medical Supplies | 25940 Greenfield Rd, Oak Park, MI 48237 | 2020-04-22 |
| 1346791183 | Kroger Co of Michigan | Pharmacy | 7644 26 Mile Rd, Shelby Township, MI 48316-5007 | 2016-10-17 |
| 1750837670 | Kroger Co of Michigan | Pharmacy | 2200 E 12 Mile Rd, Royal Oak, MI 48067-1504 | 2016-08-31 |
| 1013386986 | Kroger Co of Michigan | Durable Medical Equipment & Medical Supplies | 20891 E 13 Mile Rd, Roseville, MI 48066-4530 | 2015-09-21 |
| 1629450978 | Kroger Co of Michigan | Durable Medical Equipment & Medical Supplies | 425 N Center St, Northville, MI 48167-1263 | 2015-06-23 |
| 1912328170 | Kroger Co of Michigan | Durable Medical Equipment & Medical Supplies | 14945 23 Mile Rd, Shelby Township, MI 48315-3009 | 2013-12-13 |
| 1861824583 | Kroger Co of Michigan | Durable Medical Equipment & Medical Supplies | 2905 Union Lake Rd, Commerce Township, MI 48382-3565 | 2013-08-05 |
| 1942434287 | Kroger Co of Michigan | Durable Medical Equipment & Medical Supplies | 23191 Marter Rd, Saint Clair Shores, MI 48080-2717 | 2009-05-14 |
| 1720220197 | Kroger Co of Michigan | Durable Medical Equipment & Medical Supplies | 16450 26 Mile Rd, Macomb, MI 48042-1056 | 2009-04-01 |
| 1154576635 | Kroger Co of Michigan | Durable Medical Equipment & Medical Supplies | 4672 State St, Saginaw, MI 48603-3805 | 2008-11-25 |
| Street Address |
9741 DIXIE HWY |
| City | CLARKSTON |
| State | MI |
| Zip Code | 48348-4145 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962049783 | Amy Iannarone | Pharmacist | 9741 Dixie Hwy, Clarkston, MI 48348-4145 | 2019-12-01 |
| 1710074604 | Frederick A Marsac | Pharmacist | 9741 Dixie Hwy, Clarkston, MI 48348-4145 | 2006-10-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316548100 | Grey Street Counseling and Wellness Center, LLC | Counselor | 314 Moonlite Court, Clarkston, MI 48348 | 2020-11-06 |
| 1134787906 | Claudia Maryann Beauvais | Peer Specialist | 4533 Sedona Dr, Clarkston, MI 48348 | 2019-06-05 |
| 1669965299 | Wellbridge of Clarkston, LLC | Skilled Nursing Facility | 5655 Clarkston Road, Independence Township, MI 48348 | 2018-06-08 |
| 1164794251 | Kong C. Choi | Family Medicine | 8324 Caribou Trl., Clarkston, MI 48348 | 2012-02-03 |
| 1447587753 | Carrie Ann Schlicht | Occupational Therapist | 7508 Mecad Boulevard, Suite A, Clarkston, MI 48348 | 2009-11-06 |
| 1740424290 | Nedra Gean Downing | General Practice | 5715 Bella Rose Blvd., Ste 100, Clarkston, MI 48348 | 2009-04-28 |
| 1467600528 | Brian Davidson Dds PC | Dentist | 5720 Clarkston Road, Clarkston, MI 48348 | 2008-09-03 |
| 1962624957 | Keri Sue Hickmott | Social Worker | 9340 Dixie Highway, Clarkston, MI 48348 | 2007-05-02 |
| 1720209273 | Linda Carole Gualdoni | Physical Therapist | 7508 M.e. Cad Blvd., Suite A, Clarkston, MI 48348 | 2007-05-01 |
| 1396964466 | David William Regiani | Dentist | 10435 Ortonville Road, Suite B, Clarkston, MI 48348 | 2007-04-25 |
| Find all providers in zip 48348 | ||||
| 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 |
|---|---|---|---|---|
| 1225375603 | Zak Pharmacy LLC. | Pharmacy | 4600 E Ponce De Leon Ave Ste E, Clarkston, GA 30021-1839 | 2013-01-06 |
| 1598040271 | Walgreen Co | Pharmacy | 7110 Dixie Hwy., Clarkston, MI 48371 | 2011-10-13 |
| 1144429952 | Woodward Detroit Cvs, L.L.C. | Pharmacy | 5756 Clarkston Rd, Clarkston, MI 48348-4706 | 2007-07-12 |
| 1245300797 | Clarkston Heights Pharmacy | Pharmacy | 2119 5th Ave, Clarkston, WA 99403-1406 | 2006-11-09 |
| 1174625453 | Woodward Detroit Cvs, L.L.C. | Pharmacy | 5529 Sashabaw Rd, Clarkston, MI 48346-3147 | 2006-09-05 |
| 1346352283 | Woodward Detroit Cvs, L.L.C. | Pharmacy | 7091 Dixie Hwy, Clarkston, MI 48346-2076 | 2006-08-31 |
| 1891803268 | Pine Knob Pharmacy #3, Inc. | Pharmacy | 6770 Dixie Highway, Suite 201, Clarkston, MI 48346 | 2006-08-27 |
| 1255449625 | Pine Knob Pharmacy 4 Inc | Pharmacy | 5710 Bella Rosa Blvd, Clarkston, MI 48348-4773 | 2006-08-27 |
| 1811902943 | Walgreen Co | Pharmacy | 7110 Dixie Hwy, Clarkston, MI 48346-2014 | 2006-07-29 |
| 1679509251 | U.n. Pharmcay | Pharmacy | 3652 Market St, Unit C-1, Clarkston, GA 30021-1298 | 2006-06-24 |
| Find all providers in CLARKSTON | ||||
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| 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.