THE KROGER CO (NPI# 1982908687) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982908687 |
| Entity Type | Organization |
| Organization Name | THE KROGER CO |
| Practice Address |
505 Dacula Rd Dacula GA 30019-2125 |
| Mailing Address |
Po Box 842772 Boston MA 02284-2772 |
| Practice Telephone | 6784078739 |
| Practice Fax Number | 6784078741 |
| Mailing Telephone | 5137621019 |
| Mailing Fax Number | 5137621092 |
| Enumeration Date | 2011-01-10 |
| Last Update Date | 2017-12-21 |
| 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 |
PHRE009719 | GA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 003107006A | 05 | |
| PK | 2128329 | 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 |
505 DACULA RD |
| City | DACULA |
| State | GA |
| Zip Code | 30019-2125 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538768783 | Brian Swierczek | Pharmacist | 505 Dacula Rd, Dacula, GA 30019-2125 | 2020-10-20 |
| 1871191395 | Lucinda A Dixon | Pharmacist | 505 Dacula Rd, Dacula, GA 30019-2125 | 2020-10-16 |
| 1649823865 | Michael F Leonard | Nurse Practitioner | 505 Dacula Rd, Dacula, GA 30019-2125 | 2019-07-17 |
| 1548779408 | Crystal Aileen Mansfield | Nurse Practitioner | 505 Dacula Rd, Dacula, GA 30019-2125 | 2017-09-23 |
| 1912396953 | Joann Denise Flot Lindsey | Nurse Practitioner | 505 Dacula Rd, Dacula, GA 30019-2125 | 2015-01-14 |
| 1417345638 | Jason Daniel Murphy | Nurse Practitioner | 505 Dacula Rd, Dacula, GA 30019-2125 | 2014-12-23 |
| 1033513015 | Tlc of Georgia LLC | Nurse Practitioner | 505 Dacula Rd, Dacula, GA 30019-2125 | 2014-10-20 |
| 1770822397 | Valerie Modupeh Cole | Nurse Practitioner | 505 Dacula Rd, Dacula, GA 30019-2125 | 2013-02-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780228171 | Mackenson Lafortune | Physical Therapy Assistant | 1424 Filigree Pl, Dacula, GA 30019 | 2019-10-29 |
| 1780167452 | Adenike Alaga | Registered Nurse | 3196 Dolostone Way, Dacula, GA 30019 | 2018-09-10 |
| 1780160580 | Cielitha Ruffin | Nurse Practitioner | 1223 Bentley Estates Dr., Dacula, GA 30019 | 2018-07-15 |
| 1386135663 | Anke Mbapeh | Nurse Practitioner | 2100 Browning Bend Ct, Dacula, GA 30019 | 2018-05-23 |
| 1053820282 | Ethan Zachariah Merrow | Student in an Organized Health Care Education/Training Program | 1701 Mulberry Lake Drive, Dacula, GA 30019 | 2017-09-20 |
| 1043737547 | Dawn Hedley | Dietitian, Registered | 3567 Vern Way, Dacula, GA 30019 | 2017-08-25 |
| 1831545367 | Angela Owusu-edusei | Nurse Practitioner | 3226 Dolostone Way, Dacula, GA 30019 | 2016-05-13 |
| 1528458718 | Philomena Gyamfi | Registered Nurse | 1088 Milford Ln, Dacula, GA 30019 | 2015-01-27 |
| 1417375247 | Casey Goldman Sommerfeld | Pediatrics | 2240 Hamilton Creek Pkwy Ste 600, Dacula, GA 30019 | 2014-03-29 |
| 1417398215 | Samia Tahil | Home Health | 2821 Spence Ct, Dacula, GA 30019 | 2013-07-10 |
| Find all providers in zip 30019 | ||||
| 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 |
|---|---|---|---|---|
| 1154922441 | Southern Pharmacy Group LLC | Pharmacy | 110 Allison St., Jesup, GA 31545 | 2020-11-04 |
| 1184225526 | Svdp Georgia Community Pharmacy LLC | Pharmacy | 2050 Chamblee Tucker Rd Ste C, Chamblee, GA 30341-3343 | 2020-11-03 |
| 1194325860 | Panola Pharmacy LLC | Pharmacy | 2348 Panola Rd Unit C, Lithonia, GA 30058-5406 | 2020-10-30 |
| 1659971539 | Bob and Jeff's Hometown Pharmacy of Thomasville, LLC | Pharmacy | 309 Smith Ave, Thomasville, GA 31792-5534 | 2020-10-29 |
| 1679171979 | Dfg LLC | Pharmacy | 638 Historic Hwy 441 Suite A, Demorest, GA 30530 | 2020-10-09 |
| 1033716915 | Au Medical Center, Inc. | Pharmacy | 818 Saint Sebastian Way Ste 402, Augusta, GA 30901-2654 | 2020-10-05 |
| 1043817208 | Mlk Pharmacy2.0 | Pharmacy | 2457 Mlk Jr Dr Sw Ste A, Atlanta, GA 30311-1712 | 2020-10-01 |
| 1508470964 | Swain Drug Company LLC | Pharmacy | 855 Bowens Mill Rd Sw Suite E, Douglas, GA 31533 | 2020-09-03 |
| 1205446341 | Sunny Pharmacy | Pharmacy | 5364 Jonesboro Rd, Lake City, GA 30260-3557 | 2020-08-04 |
| 1841818044 | Hospital Authority of Miller County | Pharmacy | 213 Delores Street, Colquitt, GA 39837 | 2020-07-14 |
| Find all providers with the same taxonomy | ||||
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.