KROGER PHARMACY (NPI# 1598215840) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598215840 |
| Entity Type | Organization |
| Organization Name | KROGER PHARMACY |
| Practice Address |
6652 Youree Dr Shreveport LA 71105-4630 |
| Mailing Address |
1105 Island Park Blvd 714 Shreveport LA 71105-4741 |
| Practice Telephone | 3187959966 |
| Enumeration Date | 2016-10-11 |
| Last Update Date | 2016-10-11 |
| Authorized Official Name | RHONNY VALENTINE (PHARMACIST IN CHARGE) |
| Authorized Official Telephone | 3187959966 |
| Is Organization Subpart | Y |
| Parent Organization Name | KROGER COMPANY |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
021693 | LA | Suppliers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831640663 | Kroger Pharmacy | Pharmacy | 19 7th Ave W, Huntington, WV 25701-1734 | 2016-10-17 |
| 1265826705 | Kroger Pharmacy | Pharmacist | 16325 Ventura Blvd, Encino, CA 91436-2101 | 2015-03-23 |
| 1669711503 | Kroger Pharmacy | Pharmacist | 676 N Germantown Pkwy, Cordova, TN 38018-6210 | 2013-02-13 |
| 1740403401 | Kroger Pharmacy | Pharmacist | 1161 E Dayton Yellow Springs Rd, Fairborn, OH 45324-6325 | 2007-04-11 |
| Street Address |
6652 YOUREE DR |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71105-4630 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982777405 | The Kroger Co | Durable Medical Equipment & Medical Supplies | 6652 Youree Dr, Shreveport, LA 71105-4630 | 2006-11-15 |
| 1326457011 | Shawn Thomas | Pharmacist | 6652 Youree Dr, Shreveport, LA 71105-4630 | 2014-08-06 |
| 1396179057 | Brian James Mason | Pharmacist | 6652 Youree Dr, Shreveport, LA 71105-4630 | 2013-08-29 |
| 1437583218 | Lauren Pernici Jones | Pharmacist | 6652 Youree Dr, Shreveport, LA 71105-4630 | 2013-08-28 |
| 1215361316 | Everett Michael Wilkerson | Pharmacist | 6652 Youree Dr, Shreveport, LA 71105-4630 | 2013-08-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699245928 | Misty Johnetta Ross | Counselor | 2942 Knight St., Bldg. 4 Suite 426, Shreveport, LA 71105 | 2018-11-29 |
| 1205301868 | Tatjhana Maury | Case Manager/Care Coordinator | 3325 Youree Drive, Shreveport, LA 71105 | 2018-10-10 |
| 1245710920 | Jefferey Douglas Adair Md | Non-Pharmacy Dispensing Site | 8860 Fern Ave., Suite 120, Shreveport, LA 71105 | 2018-08-21 |
| 1679059539 | Michael E Woolbert Dds LLC | Dentist | 7600 Fern Avenue, Building 1100, Shreveport, LA 71105 | 2018-07-13 |
| 1881195675 | Adiba Bibi | Pharmacist | 3555 Greenwood Road, Walgreens, Shreveport, LA 71105 | 2018-02-27 |
| 1740796655 | Allison Borel | Counselor | 2020 E 70th St Ste 201, Shreveport, LA 71105 | 2017-12-15 |
| 1073028148 | Valerie Wooten Barcelona | Physical Therapist | 130 Kayla Street, Shreveport, LA 71105 | 2017-12-11 |
| 1710497615 | Jimmy Carroll | Counselor | 2960 Knight St, Suite 110, Shreveport, LA 71105 | 2017-10-05 |
| 1932618444 | David Louis Bennett | Counselor | 3007 Knight St., Suite 200, Shreveport, LA 71105 | 2017-09-27 |
| 1619496452 | Shaqwana Hodge | Counselor | 2920 Knight St. Suite 110, Shreveport, LA 71105 | 2017-09-13 |
| Find all providers in zip 71105 | ||||
| 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 | 71105 |
Please comment or provide details below to improve the information on KROGER PHARMACY.
| 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.