KROGER CO OF MICHIGAN (NPI# 1942434287) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942434287 |
| Entity Type | Organization |
| Organization Name | KROGER CO OF MICHIGAN |
| Other Organization Name | KROGER PHARMACY |
| Practice Address |
23191 Marter Rd Saint Clair Shores MI 48080-2717 |
| Mailing Address |
Po Box 842772 Boston MA 02284-2772 |
| Practice Telephone | 5865411370 |
| Practice Fax Number | 5865411365 |
| Mailing Telephone | 5137621019 |
| Mailing Fax Number | 5137621092 |
| Enumeration Date | 2009-05-14 |
| 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 |
5301009112 | MI | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2120334 | 01 | |
| MI | 2372833 | 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 |
| 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 |
| 1457551384 | Kroger Co of Michigan | Pharmacy | 64660 Van Dyke Rd, Washington, MI 48095-2853 | 2007-07-19 |
| Street Address |
23191 MARTER RD |
| City | SAINT CLAIR SHORES |
| State | MI |
| Zip Code | 48080-2717 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194323741 | Nesreen Altairy | Pharmacist | 23191 Marter Rd, Saint Clair Shores, MI 48080-2717 | 2020-10-15 |
| 1982241766 | Michael Joseph Zemenick | Pharmacist | 23191 Marter Rd, Saint Clair Shores, MI 48080-2717 | 2019-11-29 |
| 1891331971 | Ahtasham Ahmed | Pharmacist | 23191 Marter Rd, Saint Clair Shores, MI 48080-2717 | 2019-11-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508482084 | Farrah Aleema Rajab | Family Medicine | 24911 Little Mack Avenue, Suite C, St. Clair Shores, MI 48080 | 2020-06-22 |
| 1558986141 | Julia Anastazja Krakowska | Family Medicine | 24911 Little Mack, Suite C, St. Clair Shores, MI 48080 | 2020-06-10 |
| 1972073567 | Joyce Stepnak | Social Worker | 19611 E. 8 Mile Rd, Scs, MI 48080 | 2018-11-27 |
| 1487134177 | Bonnie Girson | Social Worker | 23409 Jefferson Ave Ste 100, Saint Clair Shores, MI 48080 | 2018-08-21 |
| 1609309913 | Park Pharmacy Scs LLC | Pharmacy | 20225 E 9 Mile Rd Ste 120a, Saint Clair Shores, MI 48080 | 2017-04-05 |
| 1730564055 | Mary Rose Giroux | Psychologist | 22516 Overlake St, St. Clair Shores, MI 48080 | 2015-07-28 |
| 1962882910 | Ali Tarif Bazzy | Family Medicine | 20225 E 9 Mile Rd Ste A, Saint Clair Shores, MI 48080 | 2015-06-04 |
| 1497156228 | Kelly Zalewski | Social Worker | 24631 Jefferson Ave, Saint Clair Shores, MI 48080 | 2014-09-11 |
| 1669871364 | Mallory Margret Gordon | Psychologist | 19900 E. 10 Mile Rd., Ste. 102, Saint Clair Shores, MI 48080 | 2014-08-19 |
| 1932549375 | Alexander Peter Bill | Otolaryngology | 22631 Greater Mack Ave Ste 200, Saint Clair Shores, MI 48080 | 2013-06-30 |
| Find all providers in zip 48080 | ||||
| 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 |
|---|---|---|---|---|
| 1558906586 | Vincents Rx LLC | Pharmacy | 29619 Harper Ave, Saint Clair Shores, MI 48082-1640 | 2019-11-13 |
| 1750865416 | Saint Clair Family Pharmacy LLC | Pharmacy | 28001 Harper Ave., Saint Clair Shores, MI 48081 | 2018-09-19 |
| 1265865372 | Madhav Pharmacy LLC | Pharmacy | 24800 Harper Ave, Suite 2, Saint Clair Shores, MI 48080-1292 | 2013-08-12 |
| 1073615365 | Woodward Detroit Cvs, L.L.C. | Pharmacy | 22515 Greater Mack Ave, Saint Clair Shores, MI 48080-2040 | 2006-09-05 |
| 1356453294 | Woodward Detroit Cvs, L.L.C. | Pharmacy | 24001 Harper Ave, Saint Clair Shores, MI 48080-1467 | 2006-08-31 |
| 1083726913 | Woodward Detroit Cvs, L.l.c | Pharmacy | 27700 Harper Ave, Saint Clair Shores, MI 48081-1506 | 2006-08-31 |
| 1033221981 | Woodward Detroit Cvs, L.L.C. | Pharmacy | 31240 Harper Ave, Saint Clair Shores, MI 48082-1402 | 2006-08-31 |
| 1467467589 | Walgreen Co | Pharmacy | 32201 Harper Ave, Saint Clair Shores, MI 48082-1408 | 2006-07-29 |
| 1891266607 | Saint Clair Shores Pharmacy LLC | Pharmacy | 23600 Harper Ave Ste 101, Saint Clair Shores, MI 48080-1445 | 2018-12-06 |
| 1790297596 | Saint Clair Pharmacy LLC | Pharmacy | 23600 Harper Ave Ste 101, Saint Clair Shores, MI 48080-1445 | 2017-11-02 |
| Find all providers in SAINT CLAIR SHORES | ||||
| City | SAINT CLAIR SHORES |
| Zip Code | 48080 |
Please comment or provide details below to improve the information on KROGER CO OF MICHIGAN.
| 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.