KROGER PHARMACY
NPI 1023042819
Pharmacy - Community/Retail Pharmacy in Lancaster, OH

Active since July 10, 2006CLIA 36D2112412 · Waiver
1621 N MEMORIAL DR, LANCASTER, OH 43130(740) 654-2044(740) 681-4069 Get Directions Write a Review

NPPES record last updated: February 4, 2020. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Feb 4, 2020, 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 1023042819) is a healthcare organization registered as a community/retail pharmacy in Lancaster, Ohio and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through April 27, 2028 and lists Jessie Warman, Manager Pharmacy Licensing, as its authorized official.

NPPES Registry Identity

NPI1023042819
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameTHE KROGER CO
Location Address1621 N MEMORIAL DRLancaster, OH 43130-1632
Mailing AddressPo Box 842772Boston, MA 02284-2772 · (513) 762-1019 · Fax (513) 762-1092
Fax(740) 681-4069
Organization SubpartNo
Authorized OfficialJessie WarmanManager Pharmacy Licensing · (513) 762-1090
Enumeration DateJuly 10, 2006
Last NPPES UpdateFebruary 4, 20202 updates tracked since enumeration
NPI 1023042819 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 OH · 020153550
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
1621 N MEMORIAL DR, Lancaster, OH 43130

Other Names 1

Doing Business AsKroger Pharmacy

Other Identifiers 2

Medicaid0371173OH
Other2075548Pk

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 36D2112412

Kroger Pharmacy #264 · Lancaster, OH
Active · expires Apr 27, 2028
CLIA Number36D2112412
Laboratory TypePharmacy
Certificate Effective DateApril 28, 2026
Certificate Expiration DateApril 27, 2028
Laboratory DirectorJeff C. Steckman
Laboratory Phone(740) 654-2044
Laboratory LocationKroger Pharmacy #2641621 N Memorial Drive, Lancaster, OH 43130
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Administration of influenza virus vaccine

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.

This service was performed 208 times for 205 patients

Administration of pneumococcal vaccine

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.

This service was performed 27 times for 27 patients

Influenza vaccine split virus, preservative free

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.

This service was performed 189 times for 188 patients

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

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.

This service was performed 25 times for 25 patients

Other Providers at the Same Location


The following 3 providers are registered at the same or a nearby location.

Nurse Practitioner (Family)
1621 N MEMORIAL DR
LANCASTER, OH 43130
Nurse Practitioner (Family)
1621 N MEMORIAL DR
LANCASTER, OH 43130
Physician Assistant (Medical)
1621 N MEMORIAL DR
LANCASTER, OH 43130

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1023042819, enumerated as an "organization" on July 10, 2006.

The provider is located at 1621 N MEMORIAL DR LANCASTER, OH 43130 and the phone number is (740) 654-2044.

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.