Kroger Co Of Michigan, NPI 1154521060
Community/Retail Pharmacy in St. Clair Shores, MI, US

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NPI number: what is it?

The NPI, or National Provider Identifier, is a non-repeatable number for health care providers. The NPI always consists of 10 digits and is used for administrative and financial procedures. The NPI wa...

NPI 1154521060
NPI Entity Type Organization
Provider Name Kroger Co Of Michigan
Doing Business As
Enumeration Date September 30, 2009
Last Update Date September 30, 2009
Certification Date September 30, 2009
Provider Location Address 22801 Harper Ave, St. Clair Shores, MI, US
Provider Mailing Address Po Box 842772, Boston, MA, US, 022842772
Gender Male
Is Sole Proprietor? No
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Organization Official

Official Name Bill Shinton
Official Position VICE PRESIDENT KROGER HEALTH
Phone 513-762-1090

Primary Taxonomy

Taxonomy Code

3336C0003X

Taxonomy Name Community/Retail Pharmacy
Classification

Pharmacy

Group

Suppliers

License No. 5301008647
License State MI
Description 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.

Other Organization Name

Kroger Pharmacy #749
Doing Business As

Business Address

Kroger Co Of Michigan
22801 Harper Ave

St. Clair Shores, MI, US

Phone: 586-800-5190
Fax: 586-800-5195

Mailing Address

Kroger Co Of Michigan
Po Box 842772
Boston, MA, US
ZIP 022842772
Phone: 513-762-1019
Fax: 513-762-1092

Secondary Taxonomies

Taxonomy Code Group Classification License No. State Primary?

332B00000X

Suppliers

Durable Medical Equipment & Medical Supplies

No

333600000X

Suppliers

Pharmacy

No

Other Identifiers

Identifier Identifier State Identifier Issuer Type/Code
2369975 MI MEDICAID 05
2042697 PK 01

Other Providers in MI, US

NPI Name Taxonomy Address

1659096923

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DR. DO, MPH Jimmy Wayne Brandon

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1891221545

Logan Morse

Individual

Pharmacist

7343 Oakhaven Ct Ne

Ada, MI

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