THE KROGER CO (NPI# 1902830748) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902830748 |
| Entity Type | Organization |
| Organization Name | THE KROGER CO |
| Other Organization Name | KROGER PHARMACY |
| Practice Address |
1606 Memorial Dr Waycross GA 31501-1949 |
| Mailing Address |
Po Box 842772 Boston MA 02284-2772 |
| Practice Telephone | 9122872277 |
| Practice Fax Number | 9122870571 |
| Mailing Telephone | 5137621019 |
| Mailing Fax Number | 5137621092 |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2016-05-16 |
| Authorized Official Name | ALLISON MUENNICH (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 |
8010 | GA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 00712577A | 05 | |
| PK | 2019554 | 01 |
| Other Name | Type Code |
|---|---|
| KROGER PHARMACY | Doing Business As Name - Organization |
| 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 |
1606 MEMORIAL DR |
| City | WAYCROSS |
| State | GA |
| Zip Code | 31501-1949 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285232090 | Charles Cannon | Pharmacist | 1606 Memorial Dr, Waycross, GA 31501-1949 | 2020-10-14 |
| 1487252227 | Laura Marie Wyatt | Pharmacist | 1606 Memorial Dr, Waycross, GA 31501-1949 | 2020-10-14 |
| 1093336521 | Jason Ted Wade | Pharmacist | 1606 Memorial Dr, Waycross, GA 31501-1949 | 2020-05-06 |
| 1225669419 | Matthew Reed | Pharmacist | 1606 Memorial Dr, Waycross, GA 31501-1949 | 2020-01-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962906115 | Davenport Health Pa | Family Medicine | 1401 Cherokee Drive, Waycross, GA 31501 | 2018-03-22 |
| 1962940478 | Blake Darren Aldridge | Physical Therapy Assistant | 401 Preston Street, Waycross, GA 31501 | 2017-02-03 |
| 1669922142 | Jebediah S. Christy Dds - Waycross Pllc | Dentist | 2271 Memorial Dr, Waycross, GA 31501 | 2016-10-10 |
| 1558721944 | Jana Kirby | Massage Therapist | 1599 Knight Ave., Kallman Chiropractic Center, Waycross, GA 31501 | 2016-02-29 |
| 1962877001 | Courtney Baldwin | Specialist/Technologist, Other | 2403 Spurgeon St, Waycross, GA 31501 | 2015-12-01 |
| 1912389784 | Grayson Stuart Griffis | Dentist | 2103 Tebeau St., Waycross, GA 31501 | 2015-06-29 |
| 1730561267 | Trishla Amit Desai | Internal Medicine | Memorial Satilla Health, 1900 Tebeau Street, Waycross, GA 31501 | 2015-06-20 |
| 1316330913 | Hanger Prosthetics & Orthotics, Inc. | Prosthetic/Orthotic Supplier | 512 City Blvd Ste H, Waycross, GA 31501 | 2015-03-06 |
| 1942699079 | Jose Ramon Martinez | Anesthesiology | 701 City Blvd, Waycross, GA 31501 | 2015-01-13 |
| 1023356714 | Orthopedics Surgeons of Georgia, LLC | Orthopaedic Surgery | 2015 Alice Street, Waycross, GA 31501 | 2013-01-30 |
| Find all providers in zip 31501 | ||||
| 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 |
|---|---|---|---|---|
| 1548205032 | Pharmacy Services Inc. | Pharmacy | 1710 Alice St, Waycross, GA 31501-5216 | 2006-06-18 |
| 1356309348 | Griffin's Prescription Shop,inc. | Pharmacy | 1408 Tebeau St, Waycross, GA 31501-5325 | 2006-05-02 |
| 1548226434 | Guardian Pharmacy of Waycross, LLC | Pharmacy | 1401 Alice St, Waycross, GA 31501-4528 | 2006-04-21 |
| 1114440724 | Walgreen Co | Pharmacy | 1803 Knight Ave, Waycross, GA 31501-8018 | 2017-07-25 |
| 1154336279 | Walgreen Co | Pharmacy | 1740 Memorial Dr, Waycross, GA 31501-1044 | 2006-07-29 |
| 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 | ||||
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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.