THE KROGER CO (NPI# 1164595682) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164595682 |
| Entity Type | Organization |
| Organization Name | THE KROGER CO |
| Practice Address |
9155 Mansfield Rd Shreveport LA 71118-3122 |
| Mailing Address |
Po Box 842772 Boston MA 02284-2772 |
| Practice Telephone | 3186882582 |
| Practice Fax Number | 3186718359 |
| Mailing Telephone | 5137621019 |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2018-03-15 |
| Authorized Official Name | ALLISON BREDESTEGE (MANAGER OF PHARMACY LICENSING) |
| Authorized Official Telephone | 5137621019 |
| 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 |
3966RC | LA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1233731 | 05 | |
| PK | 2031173 | 01 |
| 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 |
| 1043673650 | The Kroger Co | Durable Medical Equipment & Medical Supplies | 800 Glenwood Ave Se, Atlanta, GA 30316 | 2016-03-31 |
| 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 |
9155 MANSFIELD RD |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71118-3122 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346765252 | Phanid Ann Miller | Pharmacist | 9155 Mansfield Rd, Shreveport, LA 71118-3122 | 2017-08-11 |
| 1932653060 | Tammy Tran | Pharmacist | 9155 Mansfield Rd, Shreveport, LA 71118-3122 | 2016-08-05 |
| 1427467067 | Megan Hare | Pharmacist | 9155 Mansfield Rd, Shreveport, LA 71118-3122 | 2014-08-07 |
| 1982039434 | Patrick Leo Mills Jr. | Pharmacist | 9155 Mansfield Rd, Shreveport, LA 71118-3122 | 2013-09-03 |
| 1376977504 | Matthew Patton | Pharmacist | 9155 Mansfield Rd, Shreveport, LA 71118-3122 | 2013-08-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720620784 | Wk Center for Pediatric Gastroenterology | Pediatrics | Wk Center for Pediatric Gastroenterology, 2530 Bert Kouns Industrial Loop, Ste 113, Shreveport, LA 71118 | 2019-10-11 |
| 1306302443 | Diamond Marie Willis | Case Manager/Care Coordinator | 9403 Mansfield Rd., Shreveport, LA 71118 | 2019-02-13 |
| 1194224469 | Latosa Hall | Case Manager/Care Coordinator | 9007 Letha Loop, Shreveport, LA 71118 | 2018-02-01 |
| 1902321623 | Bersheika Lashay Player | Counselor | 9403 Mansfield Road, Shreveport, LA 71118 | 2017-08-03 |
| 1518487149 | Clarke Jackson | Case Manager/Care Coordinator | 9730 Baird Rd Apt 2310, Shreveport, LA 71118 | 2017-06-24 |
| 1770010449 | Darrie'l Smith | Counselor | 2715 Mackey, Shreveport, LA 71118 | 2017-05-12 |
| 1760917041 | Delilah Wells | Case Manager/Care Coordinator | 9005 Walker Rd Apt 722, Shreveport, LA 71118 | 2017-04-25 |
| 1790229664 | We Care Transporttion Services LLC | Secured Medical Transport (VAN) | 2529 Summer Grove Dr, Shreveport, LA 71118 | 2016-12-13 |
| 1063955128 | Commanisha Smith | Social Worker | 2715 Mackey Place, Shreveport, LA 71118 | 2016-11-22 |
| 1023560802 | Yasmin Newman | Counselor | 9812 West Trails End, Shreveport, LA 71118 | 2016-10-27 |
| Find all providers in zip 71118 | ||||
| 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 |
|---|---|---|---|---|
| 1689077430 | University Health Shreveport LLC | Pharmacy | 1606 Kings Hwy Rm 2263, Shreveport, LA 71103-4128 | 2014-10-07 |
| 1104268390 | Freds Stores of Tennessee Inc | Pharmacy | 5907 Old Mooringsport Road, Shreveport, LA 71107-2023 | 2013-07-29 |
| 1619058468 | Line Avenue Pharmacy Inc | Pharmacy | 1822 Line Ave, Shreveport, LA 71101-4612 | 2006-10-18 |
| 1215031141 | Louisiana Cvs Pharmacy, L.L.C. | Pharmacy | 3300 Youree Dr, Shreveport, LA 71105-2116 | 2006-09-12 |
| 1033213962 | Louisiana Cvs Pharmacy, L.L.C. | Pharmacy | 9194 Mansfield Rd, Shreveport, LA 71118-3123 | 2006-09-12 |
| 1497760664 | Walgreen Co | Pharmacy | 3124 Line Ave, Shreveport, LA 71104-4240 | 2006-07-29 |
| 1023023298 | Walgreen Co | Pharmacy | 6101 W 70th St, Shreveport, LA 71129-2507 | 2006-07-29 |
| 1235144411 | Walgreen Co | Pharmacy | 3100 N Market St, Shreveport, LA 71107-4005 | 2006-07-29 |
| 1043225212 | Walgreen Co | Pharmacy | 300 Southfield Rd, Shreveport, LA 71105-4112 | 2006-07-29 |
| 1134134307 | Walgreen Co | Pharmacy | 3555 Greenwood Rd, Shreveport, LA 71109-5209 | 2006-07-29 |
| Find all providers in SHREVEPORT | ||||
| City | SHREVEPORT |
| Zip Code | 71118 |
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.