Kroger Specialty Pharmacy, Inc., NPI 1598765570
Pharmacy in Lake Mary, FL, US
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 | 1598765570 |
| NPI Entity Type | Organization |
| Provider Name |
Kroger Specialty Pharmacy, Inc.
Doing Business As |
| Enumeration Date | September 30, 2009 |
| Last Update Date | September 30, 2009 |
| Certification Date | September 30, 2009 |
| Provider Location Address | 3200 Lake Emma Rd Unit 1000, Lake Mary, FL, US |
| Provider Mailing Address | 3200 Lake Emma Rd Unit 1000, Lake Mary, FL, US, 327463358 |
| Gender | Male |
| Is Sole Proprietor? | No |
Organization Official
| Official Name | Debra J Cole |
| Official Position | VICE PRESIDENT |
| Phone | 855-733-3126 |
Primary Taxonomy
| Taxonomy Code | |
| Taxonomy Name | Pharmacy |
| Classification | |
| Group | |
| License No. | PH17230 |
| License State | FL |
| Description | A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |
Secondary Taxonomies
| Taxonomy Code | Group | Classification | License No. | State | Primary? |
|---|---|---|---|---|---|
| No | |||||
| No |
Other Identifiers
| Identifier | Identifier State | Identifier Issuer | Type/Code |
|---|---|---|---|
| 100246590A | OK | MEDICAID | 05 |
| 1010381 | VT | MEDICAID | 05 |
| 1531290 | TN | MEDICAID | 05 |
| 1598765570 | MN | MEDICAID | 05 |
| 3087712 | NH | MEDICAID | 05 |
| 33321884 | CO | MEDICAID | 05 |
| 500628537 | OR | MEDICAID | 05 |
| 7038923 | MT | MEDICAID | 05 |
| 1044873 | WA | MEDICAID | 05 |
| 7100166410 | KY | MEDICAID | 05 |
| 7F7230 | SC | MEDICAID | 05 |
| 008003029 | CT | MEDICAID | 05 |
| 1598765570 | CA | MEDICAID | 05 |
| 582023 | TX | MEDICAID | 05 |
| 9094202 | NJ | MEDICAID | 05 |
| 0018492980003 | PA | MEDICAID | 05 |
| 003119890 | CT | MEDICAID | 05 |
| 0541920 | IA | MEDICAID | 05 |
| 1451031 | ND | MEDICAID | 05 |
| 1598765570 | ME | MEDICAID | 05 |
| 1598765570 | MI | MEDICAID | 05 |
| 2207678 | OH | MEDICAID | 05 |
| 416817800 | MD | MEDICAID | 05 |
| 0022363802 | FL | MEDICAID | 05 |
| 022363800 | FL | MEDICAID | 05 |
| 0270686 | MT | MEDICAID | 05 |
| 03105699 | NY | MEDICAID | 05 |
| 1028738 | AK | MEDICAID | 05 |
| 1598765570 | ID | MEDICAID | 05 |
| 1598765570 | NC | MEDICAID | 05 |
| 057055900 | DC | MEDICAID | 05 |
| 200297170A | IN | MEDICAID | 05 |
| 500626260 | OR | MEDICAID | 05 |
| 094403300 | MD | MEDICAID | 05 |
| 100246590B | OK | MEDICAID | 05 |
| 100444750A | KS | MEDICAID | 05 |
| 115772800 | WY | MEDICAID | 05 |
| 1598765570 | VA | MEDICAID | 05 |
| 536089 | AZ | MEDICAID | 05 |
| 1598765570 | NV | MEDICAID | 05 |
| DM1317 | SC | MEDICAID | 05 |
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MR. MAT, ATC Robert Michael Shifrin Individual |
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OTR/L Raquel Ioia Individual |
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