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KROGER PHARMACY
NPI 1053345801
Pharmacy - Community/Retail Pharmacy in North Little Rock, AR

Active since July 10, 2006CLIA 04D1021888 · Waiver
2509 MCCAIN BLVD, NORTH LITTLE ROCK, AR 72116(501) 758-9307(501) 758-9308 Get Directions Write a Review

NPPES record last updated: December 22, 2016. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Dec 22, 2016, 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 1053345801) is a healthcare organization registered as a community/retail pharmacy in North Little Rock, Arkansas and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through February 2, 2028 and lists Allison Muennich, Manager Of Pharmacy Licensing, as its authorized official.

NPPES Registry Identity

NPI1053345801
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameKROGER LIMITED PARTNERSHIP I
Location Address2509 MCCAIN BLVDNorth Little Rock, AR 72116-7606
Mailing AddressPo Box 842772Boston, MA 02284-2772 · (513) 762-1019 · Fax (513) 762-1092
Phone(501) 758-9307
Fax(501) 758-9308
Organization SubpartNo
Authorized OfficialAllison MuennichManager Of Pharmacy Licensing · (513) 762-1019
Enumeration DateJuly 10, 2006
Last NPPES UpdateDecember 22, 20162 updates tracked since enumeration
✔ NPI 1053345801 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 AR · 420113
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
2509 MCCAIN BLVD, North Little Rock, AR 72116
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Other Names 1

Doing Business AsKroger Pharmacy

Other Identifiers 5

Medicaid140045407AR
Medicare NSC1193770100
Medicare PINP01394590
Other1988185Pk
Medicare PIN10609

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 04D1021888

Kroger Pharmacy #639 · North Little Rock, AR
Active · expires Feb 2, 2028
CLIA Number04D1021888
Laboratory TypePharmacy
Certificate Effective DateFebruary 3, 2026
Certificate Expiration DateFebruary 2, 2028
Laboratory DirectorCynthia B. Fisher
Laboratory Phone(501) 758-9307
Laboratory LocationKroger Pharmacy #6392509 Mccain Blvd, North Little Rock, AR 72116
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 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.
216 services216 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.
213 services213 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.
23 services23 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.
23 services23 patients

Medical Equipment Supplier Medicare DMEPOS 14

Medicare supplier enrollment and the product categories Kroger Pharmacy 639 carries, from the Medicare DMEPOS supplier directory.

Kroger Pharmacy 639

DMEPOS supplier · North Little Rock, AROperated by Kroger Limited Partnership I
✔

Accepts Medicare assignment

Kroger Pharmacy 639 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)20599043
Medicare Participant SinceAugust 27, 2003
Supplier Location2509 Mccain BlvdNorth Little Rock, AR 72116
Phone(501) 758-9307
Supplier Specialties
Pharmacy Grocery Store

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 8

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

BETH ANN DAVENPORT PHARM.D.
Pharmacist
2509 MCCAIN BLVD
NORTH LITTLE ROCK, AR 72116
Pulaski County (501) 758-9307
DR. KAITLIN BATES PHARMD
Pharmacist
2509 MCCAIN BLVD
NORTH LITTLE ROCK, AR 72116
Pulaski County (501) 758-9307
JONATHAN BRYANT PHARM D
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
2509 MCCAIN BLVD
NORTH LITTLE ROCK, AR 72116
Pulaski County (501) 758-9307
BRADLEY THOMAS
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
2509 MCCAIN BLVD
N LITTLE ROCK, AR 72116
Pulaski County (501) 758-9307
DR. PAIGE PATTERSON CARMAN PHARM. D.
Pharmacist
2509 MCCAIN BLVD
NORTH LITTLE ROCK, AR 72116
Pulaski County (501) 758-9307
TIFFANY DIEMER PHARM. D.
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
2509 MCCAIN BLVD
NORTH LITTLE ROCK, AR 72116
Pulaski County (501) 837-1227
JOSHUA JORDAN TALLEY PHARMD
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
2509 MCCAIN BLVD
NORTH LITTLE ROCK, AR 72116
Pulaski County (501) 758-9307
ASHLEY WILSON
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
2509 MCCAIN BLVD
NORTH LITTLE ROCK, AR 72116
Pulaski County (501) 758-9307

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 1053345801. It was assigned to this organization in the NPPES registry on July 10, 2006.

Where is Kroger Limited Partnership I located?

Kroger Limited Partnership I is located at 2509 Mccain Blvd, North Little Rock, AR 72116. The listed phone number is (501) 758-9307.

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 accept Medicare assignment for medical equipment?

Yes. As a Medicare medical equipment supplier, Kroger Pharmacy 639 accepts Medicare assignment: the supplier accepts the Medicare-approved amount as payment in full for covered equipment and supplies.

Does Kroger Limited Partnership I hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 04D1021888) is associated with this NPI, valid through February 2, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Kroger Limited Partnership I accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter from Absolute Total Care, Ambetter from Arizona Complete Health and Ambetter from Arkansas Health & Wellness and 46 other insurers list Kroger Limited Partnership I as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kroger Limited Partnership I was last updated on December 22, 2016. NPI Profile syncs with the weekly NPPES data releases published by CMS.