Kroger Pharmacy #743
LBN: Kroger Co Of Michigan
Kroger Pharmacy #743 is an health care organization with primary practice located at 2200 E 12 Mile Rd , Royal Oak MI 48067-1504. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty.
Kroger Co Of Michigan can be contacted via phone (248) 397-1530, or through Bredestege, Allison via phone (513) 762-1263.
Contact Information
Primary practice address
2200 E 12 Mile Rd
Royal Oak MI 48067-1504
Phone: (248) 397-1530
Fax: (248) 397-1532
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Durable Medical Equipment & Medical Supplies | 332B00000X | ||
| Suppliers / Pharmacy | 333600000X | ||
| Suppliers / Community/Retail Pharmacy | 3336C0003X | 5301011042 | Michigan |
Profile Details
| NPI number | 1750837670 |
|---|---|
| LBN Legal business name | Kroger Co Of Michigan |
| DBA Doing business as | Kroger Pharmacy #743 |
| Authorized official | Bredestege, Allison |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Aug 31st, 2016 |
| Last updated | Jan 17th, 2017 - about 7 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1750837670 | NPPES |
| Michigan | MEDICAID | 1750837670 | |
| Michigan | Other | 2163907 |
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