KROGER PHARMACY
NPI 1003840851
Pharmacy - Community/Retail Pharmacy in Waterford, MI

Active since July 10, 2006CLIA 11D2327342 · Waiver
5111 HIGHLAND RD, WATERFORD, MI 48327(248) 673-4324(810) 673-7318 Get Directions Write a Review

NPPES record last updated: January 25, 2019. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jan 25, 2019, May 16, 2016 (2 updates tracked since 2016).

About Kroger Pharmacy NPPES

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

KROGER PHARMACY (NPI 1003840851) is a healthcare organization registered as a community/retail pharmacy in Waterford, Michigan and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through July 21, 2027 and lists Jessie Warman, Manager Rx Licensing, as its authorized official.

NPPES Registry Identity

NPI1003840851
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameKROGER CO OF MICHIGAN
Location Address5111 HIGHLAND RDWaterford, MI 48327-1915
Mailing AddressPo Box 842772Boston, MA 02284-2772 · (513) 762-1019 · Fax (513) 762-1092
Fax(810) 673-7318
Organization SubpartNo
Authorized OfficialJessie WarmanManager Rx Licensing · (513) 762-1090
Enumeration DateJuly 10, 2006
Last NPPES UpdateJanuary 25, 20192 updates tracked since enumeration
NPI 1003840851 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 MI · 5301007041
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
5111 HIGHLAND RD, Waterford, MI 48327

Other Names 1

Doing Business AsKroger Pharmacy

Other Identifiers 2

Medicaid4113915MI
Other2044492Pk

Accepted Insurance

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 11D2327342

Kroger Pharmacy #011-686 · Hoschton, GA
Active · expires Jul 21, 2027
CLIA Number11D2327342
Laboratory TypePharmacy
Certificate Effective DateJuly 22, 2025
Certificate Expiration DateJuly 21, 2027
Laboratory DirectorChuck Page
Laboratory Phone(513) 762-1090
Laboratory LocationKroger Pharmacy #011-686175 Peachtree Exchange, Hoschton, GA 30548
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the 2024 & 2026 CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
120 services119 patients
Influenza vaccine split virus, preservative free 90662
The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.
118 services117 patients

Medical Equipment Supplier

The provider carries the following medical supplies product categories:

PTAN
20410727
Accepts Medicare Assignment
YES
Specialities List
Pharmacy, Grocery Store.
Competitive Bidding
NO

Supplies List

  • Immunosuppressive Drugs - Immunosuppressive drugs require dosage, frequency, and route of administration to prevent or treat the rejection of an organ transplant
  • Nebulizer Drugs - Albuterol, levalbuterol, and metaproterenol are all short-acting bronchodilators with beta-adrenergic stimulatory effect
  • Oral Anticancer Drugs - FDA anticancer drugs
  • Oral Antiemetic Drugs - FDA antiemetic drugs
  • Commodes, Urinals, Bedpans - Raised toilets, Drop-arm commodes, Folding commodes, Plastic urinals, Plastic bedpans, Disposable urinals
  • Blood Glucose Monitors/Supplies (Non-Mail Order) - Home blood glucose monitors including lancets, reagent strips, and other supplies necessary for the proper functioning of the device
  • Canes and/or Crutches - Standard Canes, Quad Canes, Offset Canes, Standard Crutches, Forearm Crutches
  • Walkers - Standard Walkers, Wheeled Walkers, Folding Walker
  • Ostomy Supplies - Pouches, Paste, Powder, Barrier wipes
  • Urological Supplies - Catheters, Urinary collection devices
  • Enteral Nutrients - Enteral formula
  • Enteral Equipment and/or Supplies - Enteral infusion pumps, enteral nutrition supply kits
  • Nebulizer Equipment and/or Supplies - Nebulizers, Atomizers, Filters
  • Surgical Dressings - Gauze, Elastic bandages, Adhesive tape

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Pharmacist
5111 HIGHLAND RD
WATERFORD, MI 48327
Pharmacist
5111 HIGHLAND RD
WATERFORD, MI 48327
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
5111 HIGHLAND RD
WATERFORD, MI 48327
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
5111 HIGHLAND RD
WATERFORD, MI 48327
Pharmacist
5111 HIGHLAND RD
WATERFORD, MI 48327
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
5111 HIGHLAND RD
WATERFORD, MI 48327

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1003840851, enumerated as an "organization" on July 10, 2006.

The provider is located at 5111 HIGHLAND RD WATERFORD, MI 48327 and the phone number is (248) 673-4324.

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

The provider might be accepting Accepts: Alliant Health Plans, Inc., Ambetter from Absolute. Please consult your insurance carrier or call the provider to verify.