KROGER CO OF MICHIGAN (NPI# 1902096001) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902096001 |
| Entity Type | Organization |
| Organization Name | KROGER CO OF MICHIGAN |
| Other Organization Name | KROGER PHARMACY |
| Practice Address |
30851 Gratiot Ave Roseville MI 48066-1769 |
| Mailing Address |
Po Box 842772 Boston MA 02284-2772 |
| Practice Telephone | 5865413314 |
| Practice Fax Number | 5865413320 |
| Mailing Telephone | 5137621019 |
| Mailing Fax Number | 5137621092 |
| Enumeration Date | 2007-07-26 |
| 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 |
|---|---|---|---|---|---|
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
5301008656 | MI | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 2369925 | 05 | |
| PK | 2042692 | 01 |
| 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 |
30851 GRATIOT AVE |
| City | ROSEVILLE |
| State | MI |
| Zip Code | 48066-1769 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720003387 | Bormans Inc | Pharmacy | 30851 Gratiot Ave, Roseville, MI 48066-1769 | 2006-07-13 |
| 1164069936 | Paul Donald Schroff | Pharmacist | 30851 Gratiot Ave, Roseville, MI 48066-1769 | 2019-11-29 |
| 1346886132 | Roy Toubassi | Pharmacist | 30851 Gratiot Ave, Roseville, MI 48066-1769 | 2019-11-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437761400 | Louay Mansour Dds PC | Dentist | 27845 Gratiot Avenue, Roseville, MI 48066 | 2020-08-20 |
| 1558911842 | Jomy Jose | Nurse Practitioner | 25719 Salem St, Roseville, MI 48066 | 2019-09-18 |
| 1053963033 | Convenient Rv PC | Dentist | 19551 E. 10 Mile Rd, Roseville, MI 48066 | 2019-07-10 |
| 1063914539 | Colleen Meriweather | Registered Nurse | 27300 Spruce, Rosevilel, MI 48066 | 2018-03-01 |
| 1326565789 | Renee Suzette Hoelzeman | Nurse Practitioner | 18472 Meier St, Roseville, MI 48066 | 2017-08-27 |
| 1225561400 | Eugenia Dillard | Counselor | 28351 Gratiot Ave., Suite 3, Roseville, MI 48066 | 2017-04-05 |
| 1932651338 | Julie Plichota | Physical Therapist | 31120 Gratiot Ave, Roseville, MI 48066 | 2016-11-01 |
| 1699221325 | Jaquenta Glasker | Technician, Other | 26778 Rosewood, Roseville, MI 48066 | 2016-09-01 |
| 1609296144 | Peter Jajou | Dermatology | 18285 E 10 Mile Rd Ste 130, Roseville, MI 48066 | 2014-04-23 |
| 1619393899 | Katherine Michelle Johnson | Obstetrics & Gynecology | 29751 Little Mack Ave Ste B, Roseville, MI 48066 | 2014-03-11 |
| Find all providers in zip 48066 | ||||
| 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 |
|---|---|---|---|---|
| 1497181523 | Remedyrx Pharmacy | Pharmacy | 1420 E Roseville Pkwy Ste 130, Roseville, CA 95661-3081 | 2013-09-20 |
| 1639329816 | Rbf LLC | Pharmacy | 1201 Larpenteur Ave W, Roseville, MN 55113-6318 | 2008-09-24 |
| 1053469866 | Kaiser Foundation Health Plan Inc | Pharmacy | 1600 Eureka Rd Fl 2, Roseville, CA 95661-3027 | 2007-01-08 |
| 1760530372 | Kaiser Foundation Health Plan Inc | Pharmacy | 1840 Sierra Gardens Dr, Roseville, CA 95661-2912 | 2007-01-08 |
| 1891886974 | Family Drug Pharmacy, Inc | Pharmacy | 19011 E 10 Mile Rd Ste B, Roseville, MI 48066-3901 | 2006-09-27 |
| 1508978446 | Woodward Detroit Cvs, L.L.C. | Pharmacy | 28774 Gratiot Ave, Roseville, MI 48066-4257 | 2006-08-31 |
| 1558471219 | Bel Air Market Inc | Pharmacy | 1039 Sunrise Ave, Roseville, CA 95661-7004 | 2006-08-30 |
| 1255344883 | Axlines Inc | Pharmacy | 125 North Main St, Roseville, IL 61473 | 2006-08-14 |
| 1245246883 | Walgreen Co | Pharmacy | 2635 Rice St, Roseville, MN 55113-3717 | 2006-08-01 |
| 1457373151 | Garfield Beach Cvs LLC | Pharmacy | 10451 Fairway Dr, Roseville, CA 95678-1987 | 2006-07-24 |
| Find all providers in ROSEVILLE | ||||
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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.