KROGER CO OF MICHIGAN
NPI 1013386986
Pharmacy - Community/Retail Pharmacy in Roseville, MI

Q: What is Kroger Co Of Michigan's NPI number?

The NPI number for Kroger Co Of Michigan is 1013386986. It was assigned to this organization in the NPPES registry on September 21, 2015. The provider is doing business as Kroger Pharmacy #774.

Q: What is Kroger Co Of Michigan's specialty?

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

Active since September 21, 2015CLIA 23D2077079 · Waiver

20891 E 13 MILE RD, ROSEVILLE, MI 48066(586) 298-3855(586) 298-3857 Get Directions Write a Review

NPPES record last updated: September 19, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 19, 2025, Jul 19, 2018, Apr 18, 2018 and 3 more (6 updates tracked since 2015).

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About Kroger Co Of Michigan NPPES

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

KROGER CO OF MICHIGAN (NPI 1013386986), doing business as Kroger Pharmacy #774, is a healthcare organization registered as a community/retail pharmacy in Roseville, Michigan and active in the NPI registry since September 2015. The organization holds a CLIA Waiver certificate valid through April 29, 2028 and lists Allison Muennich, Manager Of Pharmacy Licensing, as its authorized official.

NPPES Registry Identity

NPI1013386986

Entity TypeOrganization

Primary Taxonomy3336C0003X

Legal Business NameKROGER CO OF MICHIGAN

Location Address20891 E 13 MILE RDRoseville, MI 48066-4530

Mailing AddressPo Box 842772Boston, MA 02284-2772 · (513) 762-1019 · Fax (513) 762-1092

Phone(586) 298-3855

Fax(586) 298-3857

Organization SubpartNo

Authorized OfficialAllison MuennichManager Of Pharmacy Licensing · (513) 762-1019

Enumeration DateSeptember 21, 2015

Last NPPES UpdateSeptember 19, 20256 updates tracked since enumeration

✔ NPI 1013386986 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers

Taxonomy Code3336C0003X

License✔ Licensed in MI · 5301010765

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

20891 E 13 MILE RD, Roseville, MI 48066

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Other Names 1

Doing Business AsKroger Pharmacy #774

Other Identifiers 1

Other2154197Pk

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arizona Complete Health and more.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 23D2077079

Kroger Co Of Michigan, The · Roseville, MI

Active · expires Apr 29, 2028

CLIA Number23D2077079

Laboratory TypeRetail Pharmacy

Certificate Effective DateApril 30, 2026

Certificate Expiration DateApril 29, 2028

Laboratory DirectorRobert Brown

Laboratory Phone(586) 776-8583

Laboratory LocationKroger Co Of Michigan, The26130 Gratiot Kroger Pharmacy 018-663 Attn Pharmacist In Charge, Roseville, MI 48066

CLIA data matches this NPI record on: Name

This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the 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.

165 services165 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.

156 services156 patients

Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677

The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.

44 services44 patients

Administration of pneumococcal vaccine G0009

The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.

44 services44 patients

Medical Equipment Supplier Medicare DMEPOS 14

Medicare supplier enrollment and the product categories Kroger Pharmacy #774 carries, from the Medicare DMEPOS supplier directory.

Kroger Pharmacy #774

DMEPOS supplier · Roseville, MIOperated by Kroger Co Of Michigan

✔

Accepts Medicare assignment

Kroger Pharmacy #774 agrees to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients are not billed beyond the standard deductible and coinsurance.

PTAN (Medicare Supplier Number)20410391

Medicare Participant SinceNovember 5, 2020

Supplier Location20891 E 13 Mile RdRoseville, MI 48066

Phone(586) 298-3855

Supplier Specialties

Pharmacy

Medicare Product Categories

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

Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

Other Providers at the Same Location NPPES 5

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

AHMED ALEMARA

Pharmacist