KROGER SPECIALTY INFUSION AL, LLC (NPI# 1346210549) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346210549 |
| Entity Type | Organization |
| Organization Name | KROGER SPECIALTY INFUSION AL, LLC |
| Other Organization Name | KROGER SPECIALTY INFUSION AL |
| Practice Address |
2511 Ross Clark Cir Dothan AL 36301-4912 |
| Mailing Address |
2511 Ross Clark Circle Dothan AL 36301 |
| Practice Telephone | 3347941126 |
| Practice Fax Number | 3347930592 |
| Mailing Telephone | 3347941126 |
| Mailing Fax Number | 3347930592 |
| Enumeration Date | 2006-01-23 |
| Last Update Date | 2020-05-08 |
| Authorized Official Name | DEBRA J COLE (VICE PRESIDENT) |
| Authorized Official Telephone | 8557333126 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| N | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
Suppliers | ||
| N | 3336S0011X |
Pharmacy Specialization: Specialty Pharmacy |
Suppliers | ||
| Y | 3336H0001X |
Pharmacy Specialization: Home Infusion Therapy Pharmacy |
110739 | AL | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 031036101 | 05 | |
| AL | 100003469 | 05 | |
| GA | 003159485B | 05 | |
| FL | 031036100 | 05 | |
| AL | 009920285 | 05 | |
| PK | 1993756 | 01 | |
| GA | 003188543A | 05 |
| Other Name | Type Code |
|---|---|
| Kroger Specialty Infusion AL | Doing Business As Name - Organization |
| Street Address |
2511 ROSS CLARK CIR |
| City | DOTHAN |
| State | AL |
| Zip Code | 36301-4912 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043862931 | Pharmacy Center South LLC | Pharmacy | 2826 Ross Clark Circle, Suite 103, Dothan, AL 36301 | 2019-07-11 |
| 1851879167 | Attallah Cotton | Social Worker | 101 Eastridge Dr, Dothan, AL 36301 | 2018-07-31 |
| 1225522709 | Nichole Johnson Prestwood | Nurse Practitioner | 2431 W Main St Ste 501, Dothan, AL 36301 | 2018-06-19 |
| 1750805818 | Kimberly Danielle Austin | Speech-Language Pathologist | 404 Darlington Cir, Dothan, AL 36301 | 2017-07-31 |
| 1952794885 | Lori P. Granberry | Pharmacist | 2131 Ross Clark Circle, Dothan, AL 36301 | 2015-03-17 |
| 1801286059 | Robert Cody Russell | Nurse Practitioner | 1118 Ross Clark Circle, Suite 100, Dothan, AL 36301 | 2015-01-27 |
| 1720407646 | Michael Kreger | Anesthesiology | 1118 Ross Clark Cir Ste 700, Dothan, AL 36301 | 2014-04-08 |
| 1063851277 | Carlos Stanford Clark II | Family Medicine | 201 Doctors Drive, Dothan, AL 36301 | 2013-06-20 |
| 1639489313 | Robert Fort Hambaugh Jr. | Specialist | 712 Woodland Drive, Dothan, AL 36301 | 2010-10-15 |
| 1588894976 | Atwill Lamar Miller Jr. | Urology | 1908 Fairview Avenue, Dothan, AL 36301 | 2009-07-20 |
| Find all providers in zip 36301 | ||||
| Taxonomy Code | 3336H0001X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Home Infusion Therapy Pharmacy |
| Pharmacy-based, decentralized patient care organization with expertise in USP 797-compliant sterile drug compounding that provides care to patients with acute or chronic conditions generally pertaining to parenteral administration of drugs, biologics and nutritional formulae administered through catheters and/or needles in home and alternate sites. Extensive professional pharmacy services, care coordination, infusion nursing services, supplies and equipment are provided to optimize efficacy and compliance. |
| Notes: Source: National Home Infusion Association [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578841623 | Ihs Acquisition Xxx, Inc. | Pharmacy | 2811 Horace Shepard Dr, Suite 100, Dothan, AL 36303-1038 | 2011-07-22 |
| 1407890106 | Triad of Alabama LLC | Pharmacy | 119 S Woodburn Dr, Suite 2, Dothan, AL 36305-1050 | 2006-06-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912205758 | Baitshop Investments, Inc. | Pharmacy | 5129 Highway 17, Helena, AL 35080-3514 | 2011-03-02 |
| 1720301054 | Southern Hemophilia Infusion | Pharmacy | 154 Hand Ave, Bay Minette, AL 36507-4825 | 2010-03-01 |
| 1104984111 | Coag Therapeutics South Inc. | Pharmacy | 53 N Jackson St, Mobile, AL 36602-2809 | 2006-12-04 |
| 1750399762 | Advanced Home Care Inc | Pharmacy | 302 Bay St, Gadsden, AL 35901 | 2006-08-04 |
| 1942266499 | Modern Medical Concepts Homecare, Inc | Pharmacy | 110 Mmc Pkwy, Rainbow City, AL 35906-5852 | 2006-04-25 |
| 1750532677 | Midsouth | Pharmacy | 2200 Riverchase Ctr, Bld 700 Ste 700, Birmingham, AL 35244-2866 | 2008-10-09 |
| 1033246178 | Solutions Infusion Therapy | Pharmacy | 2701 4th Ave S, Birmingham, AL 35233-2707 | 2007-02-27 |
| 1518978550 | Vitalstat, Inc. | Pharmacy | 103 Sand Mountain Dr Ne, Albertville, AL 35950-1709 | 2006-08-11 |
| 1093740185 | Ritch's Vital Care of Birmingham, Inc. | Pharmacy | 2714 Cahaba Rd, Birmingham, AL 35223-2304 | 2006-07-11 |
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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.