Kroger Pharmacy

LBN: Kroger Co Of Michigan
Kroger Pharmacy is an health care organization with primary practice located at 19855 W 12 Mile Rd , Southfield MI 48076-2561. 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) 559-0801, or through Warman, Jessie via phone (513) 762-1090.

Contact Information

Primary practice address
19855 W 12 Mile Rd Southfield MI 48076-2561
Fax: (248) 559-0804
Website:
Authorized official contact:
Name: Warman, Jessie

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X 5301007015 Michigan

Profile Details

NPI number 1932133782
LBN Legal business name Kroger Co Of Michigan
DBA Doing business as Kroger Pharmacy
Authorized official Warman, Jessie
Entity Organization
Organization subpart 1 No
Enumeration date Jul 10th, 2006
Last updated Jan 25th, 2019 - about 5 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1932133782 NPPES
Michigan MEDICAID 4098659
Michigan Other 2044473

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