KROGER CO OF MICHIGAN (NPI# 1518360791) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518360791 |
| Entity Type | Organization |
| Organization Name | KROGER CO OF MICHIGAN |
| Other Organization Name | KROGER PHARMACY #447 |
| Practice Address |
23101 John R Rd Hazel Park MI 48030-1475 |
| Mailing Address |
Po Box 842772 Boston MA 02284-2772 |
| Practice Telephone | 2486581660 |
| Practice Fax Number | 2486581665 |
| Mailing Telephone | 5137621019 |
| Mailing Fax Number | 5137621092 |
| Enumeration Date | 2014-10-02 |
| 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 |
5301010599 | MI | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2148238 | 01 | |
| MI | 2898585 | 05 |
| Other Name | Type Code |
|---|---|
| Kroger Pharmacy #447 | 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 |
| 1942434287 | Kroger Co of Michigan | Durable Medical Equipment & Medical Supplies | 23191 Marter Rd, Saint Clair Shores, MI 48080-2717 | 2009-05-14 |
| 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 |
| Street Address |
23101 JOHN R RD |
| City | HAZEL PARK |
| State | MI |
| Zip Code | 48030-1475 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568487122 | Bormans Inc | Pharmacy | 23101 John R Rd, Hazel Park, MI 48030-1475 | 2006-07-13 |
| 1497391445 | Lea Mae Olson | Pharmacist | 23101 John R Rd, Hazel Park, MI 48030-1475 | 2019-11-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710254511 | Dennis Lee Levine | Family Medicine | 1142 E. 9 Mile Rd, Hazel Park, MI 48030 | 2011-11-22 |
| 1316167471 | Irwin Arnold Goodman | Dentist | 23941 John R., Hazel Park, MI 48030 | 2007-04-30 |
| 1053447490 | Thomas N Weigel Dds PC | Dentist | 23411 John R Street, Hazel Park, MI 48030 | 2007-02-27 |
| 1871668400 | Back In Line Chiropractic PC | Chiropractor | 712 E. 9 Mile Rd, Hazel Park, MI 48030 | 2006-11-21 |
| 1215025796 | Christopher Yon Chang | Physical Medicine & Rehabilitation | 704 E 9 Mile Rd, Hazel Park, MI 48030 | 2006-10-10 |
| 1043320302 | Ashtar Dentistry P.C. | Dentist | 23528 John R. Rd., Hazel Partk, MI 48030 | 2006-08-30 |
| 1477544088 | Musib S Gappy | Internal Medicine | 23411 John R, Hazel Park, MI 48030 | 2005-11-02 |
| 1639210693 | Basima Ykao Ykao-daman | Dentist | 23528 John R. Rd., Hazel Park, MI 48030 | 2007-02-10 |
| 1871674275 | Eye On Health P.C. | Optometrist | 22039 John R Rd, Hazal Park, MI 48030 | 2006-10-18 |
| 1356470520 | Randy Gordon Fillion | Massage Therapist | 98 W Garfield Ave, Hazel Park, MI 48030-1128 | 2007-03-05 |
| Find all providers in zip 48030 | ||||
| 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 |
|---|---|---|---|---|
| 1457994170 | John R Rx LLC | Pharmacy | 21670 John R Rd Ste 5, Hazel Park, MI 48030-2015 | 2019-10-25 |
| 1154721520 | Dynamic Pharmacy and Health Solutions LLC. | Pharmacy | 350 E 9 Mile Rd, Hazel Park, MI 48030-1854 | 2014-09-03 |
| 1629357645 | Advance Care Pharmacy PC | Pharmacy | 24822 John R Rd, Hazel Park, MI 48030-1147 | 2011-08-08 |
| 1508955584 | Marinco Pharmacy Inc | Pharmacy | 21936 Vassar Ave, Hazel Park, MI 48030-1828 | 2006-10-11 |
| 1073625919 | Woodward Detroit Cvs, L.L.C. | Pharmacy | 33 West Nine Mile Rd., Hazel Park, MI 48030-1413 | 2006-08-31 |
| 1154300267 | Rx Specialities Nh Inc | Pharmacy | 23751 Dequindre Rd, Hazel Park, MI 48030-2817 | 2006-01-17 |
| 1538729579 | Wrigley's Pharmacy 3, LLC | Pharmacy | 20721 Dequindre Rd Ste B, Hazel Park, MI 48030-2633 | 2019-06-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609477389 | Rose Rex LLC | Pharmacy | 2330 S Milford Rd Ste 114, Highland, MI 48357-4982 | 2020-11-08 |
| 1508466194 | Grand Gratiot Pharmacy, LLC | Pharmacy | 7011 Gratiot Ave Ste 100, Detroit, MI 48207-1973 | 2020-10-31 |
| 1104424530 | Advance Care Rx, LLC | Pharmacy | 500 N Cass St, Berrien Springs, MI 49103-1069 | 2020-10-16 |
| 1023616554 | Henry Ford Health System | Pharmacy | 2800 W Grand Blvd, Detroit, MI 48208 | 2020-10-16 |
| 1881292001 | Healthwatch Pharmacy Inc | Pharmacy | 1375 S Lapeer Rd Ste 102, Lake Orion, MI 48360-1421 | 2020-10-09 |
| 1225645781 | Good Choice Pharmacy LLC | Pharmacy | 6750 E 10 Mile Rd, Center Line, MI 48015-1166 | 2020-09-29 |
| 1487269122 | Canfield Pharmacy LLC | Pharmacy | 4673 Conner St, Detroit, MI 48215-2028 | 2020-09-10 |
| 1851905707 | Skidway Pharmacy LLC | Pharmacy | 1830 Greenwood Rd, Prescott, MI 48756-8627 | 2020-09-08 |
| 1023621190 | Azam Mohsen Mesleh | Pharmacy | 6811 Theisen St, Dearborn, MI 48126-1927 | 2020-08-28 |
| 1821606310 | S&k Pharmacy Inc. | Pharmacy | 1916 Davison Rd, Flint, MI 48506-4423 | 2020-07-21 |
| Find all providers with the same taxonomy | ||||
| City | HAZEL PARK |
| Zip Code | 48030 |
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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.