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KROGER PHARMACY J-11
NPI 1013080530
Pharmacy - Community/Retail Pharmacy in Indianapolis, IN

Active since November 15, 2006CLIA Certified · 2 labs
8939 E 38TH ST, INDIANAPOLIS, IN 46226(317) 899-7077(317) 899-7078 Get Directions Write a Review

NPPES record last updated: June 24, 2009. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Kroger Pharmacy J-11 NPPES

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

KROGER PHARMACY J-11 (NPI 1013080530) is a healthcare organization registered as a community/retail pharmacy in Indianapolis, Indiana and active in the NPI registry since November 2006. The organization holds 2 active CLIA laboratory certificates and lists Matt Mineer, Interface Manager, as its authorized official.

NPPES Registry Identity

NPI1013080530
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameKROGER LIMITED PARTNERSHIP I
Location Address8939 E 38TH STIndianapolis, IN 46226-6032
Mailing Address5960 Castleway West DrIndianapolis, IN 46250-1977 · (317) 579-8434 · Fax (317) 579-8424
Phone(317) 899-7077
Fax(317) 899-7078
Organization SubpartNo
Authorized OfficialMatt MineerInterface Manager · (513) 387-7074
Enumeration DateNovember 15, 2006
Last NPPES UpdateJune 24, 2009
✔ NPI 1013080530 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 IN · 60005133
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
8939 E 38TH ST, Indianapolis, IN 46226
Open in Google Maps ↗

Other Names 1

Doing Business AsKroger Pharmacy J-11

Other Identifiers 5

Medicaid100378410AIN
Medicare PINP00637372
Other1531284Ncpdp Provider Identification Number
Medicare NSC1193770021
Medicare PIN256660

CLIA Laboratory Certificates CMS CLIA 2

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 15D1021823

Kroger Limited Partnership · Indianapolis, IN
Active · expires Feb 1, 2028
CLIA Number15D1021823
Laboratory TypeOther
Certificate Effective DateFebruary 2, 2026
Certificate Expiration DateFebruary 1, 2028
Laboratory DirectorLeslie Lake
Laboratory Phone(317) 579-8434
Laboratory LocationKroger Limited Partnership5960 Castleway W Dr, Indianapolis, IN 46250
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 14D1078341

Kroger Pharmacy J-531 · Bartonville, IL
Active · expires Jan 7, 2028
CLIA Number14D1078341
Laboratory TypePharmacy
Certificate Effective DateJanuary 8, 2026
Certificate Expiration DateJanuary 7, 2028
Laboratory DirectorStacy Doyle
Laboratory Phone(317) 579-8434
Laboratory LocationKroger Pharmacy J-5311405 W Garfield, Bartonville, IL 61607
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

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

DR. MICHAEL LYDICK D.D.S.
Dentist (General Practice)
8939 E 38TH ST, #23
INDIANAPOLIS, IN 46226
Marion County (317) 898-2822
DR. GIANNA MOHRMAN DDS
Dentist
8939 E 38TH ST
INDIANAPOLIS, IN 46226
Marion County (317) 898-2822
GIANNA MOHRMAN D.D.S., P.C
Dentist (General Practice)
8939 E 38TH ST
INDIANAPOLIS, IN 46226
Marion County (317) 898-2822

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kroger Limited Partnership I's NPI number?

The NPI number for Kroger Limited Partnership I is 1013080530. It was assigned to this organization in the NPPES registry on November 15, 2006. The provider is doing business as Kroger Pharmacy J-11.

Where is Kroger Limited Partnership I located?

Kroger Limited Partnership I is located at 8939 E 38th St, Indianapolis, IN 46226. The listed phone number is (317) 899-7077.

What is Kroger Limited Partnership I's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

Does Kroger Limited Partnership I hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Kroger Limited Partnership I was last updated on June 24, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.