KROGER PHARMACY
NPI 1003840810
Pharmacy - Community/Retail Pharmacy in Richmond Hill, GA

Active since July 10, 2006CLIA 11D2313445 · Waiver
9701 FORD AVE, RICHMOND HILL, GA 31324(912) 756-2255(912) 756-2607 Get Directions Write a Review

NPPES record last updated: September 29, 2009. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Kroger Pharmacy NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KROGER PHARMACY (NPI 1003840810) is a healthcare organization registered as a community/retail pharmacy in Richmond Hill, Georgia and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through October 30, 2026 and lists Matt Mineer, Interface Manager, as its authorized official.

NPPES Registry Identity

NPI1003840810
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameTHE KROGER CO
Location Address9701 FORD AVERichmond Hill, GA 31324-6422
Mailing Address2175 Parklake Dr NeAtlanta, GA 30345-2845 · (770) 496-5332 · Fax (770) 496-7562
Fax(912) 756-2607
Organization SubpartNo
Authorized OfficialMatt MineerInterface Manager · (513) 387-7074
Enumeration DateJuly 10, 2006
Last NPPES UpdateSeptember 29, 2009
NPI 1003840810 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
License Licensed in GA · 8330
Definition

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.

Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X
Also ListedPharmacyTaxonomy 333600000X
9701 FORD AVE, Richmond Hill, GA 31324

Other Names 1

Doing Business AsKroger Pharmacy

Other Identifiers 5

Medicare NSC0302060799
Other1146516Ncpdp Provider Identification Number
Medicare PINP00003265
Medicaid00839583AGA
Medicare PINFLU346

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 11D2313445

Kroger Pharmacy #011-639 · Lawrenceville, GA
Active · expires Oct 30, 2026
CLIA Number11D2313445
Laboratory TypePharmacy
Certificate Effective DateOctober 31, 2024
Certificate Expiration DateOctober 30, 2026
Laboratory DirectorChuck Page
Laboratory Phone(770) 496-5332
Laboratory LocationKroger Pharmacy #011-6391006 Martins Chapel Road, Lawrenceville, GA 30045
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1003840810, enumerated as an "organization" on July 10, 2006.

The provider is located at 9701 FORD AVE RICHMOND HILL, GA 31324 and the phone number is (912) 756-2255.

Pharmacy with taxonomy code 3336C0003X and a focus in Community/Retail Pharmacy.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.