KROGER PHARMACY #644
NPI 1083774210
Pharmacy - Community/Retail Pharmacy in Little Rock, AR

Q: What is Kroger Limited Partnership I's NPI number?

The NPI number for Kroger Limited Partnership I is 1083774210. It was assigned to this organization in the NPPES registry on December 11, 2006. The provider is doing business as Kroger Pharmacy #644.

Q: 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.

Active since December 11, 2006CLIA 04D1021889 · Waiver

1900 N POLK ST, LITTLE ROCK, AR 72207(501) 663-3257(501) 663-3426 Get Directions Write a Review

NPPES record last updated: May 16, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Kroger Pharmacy #644 NPPES

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

KROGER PHARMACY #644 (NPI 1083774210) is a healthcare organization registered as a community/retail pharmacy in Little Rock, Arkansas and active in the NPI registry since December 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

NPI1083774210

Entity TypeOrganization

Primary Taxonomy3336C0003X

Legal Business NameKROGER LIMITED PARTNERSHIP I

Location Address1900 N POLK STLittle Rock, AR 72207-4634

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

Phone(501) 663-3257

Fax(501) 663-3426

Organization SubpartNo

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

Enumeration DateDecember 11, 2006

Last NPPES UpdateMay 16, 2016

✔ NPI 1083774210 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 · 0420090

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

1900 N POLK ST, Little Rock, AR 72207

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Other Names 1

Doing Business AsKroger Pharmacy #644

Other Identifiers 5

Medicare PINP01394590

Medicaid140047407AR

Medicare NSC1193770098

Other1988190Pk

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 04D1021889

Kroger Pharmacy 644 · Little Rock, AR

Active · expires Feb 2, 2028

CLIA Number04D1021889

Laboratory TypePharmacy

Certificate Effective DateFebruary 3, 2026

Certificate Expiration DateFebruary 2, 2028

Laboratory DirectorCynthia B. Fisher

Laboratory Phone(501) 663-3257

Laboratory LocationKroger Pharmacy 6441900 North Polk, Little Rock, AR 72207

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 5

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.

377 services374 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.

373 services370 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.

45 services45 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.

45 services45 patients

Severe acute respiratory syndrome coronavirus 2 (covid-19) vaccine, recombinant spike protein nanoparticle, saponin-based adjuvant, preservative free, 5 mcg/0.5ml dosage, for intramuscular use 91304

The COVID-19 vaccine you'll receive is designed to protect against the virus. It contains tiny, harmless pieces of the virus's spike protein. These trigger your immune system to build a defense. The vaccine also includes a saponin-based adjuvant to enhance this response. It's given as a 0.5ml injection into a muscle.

19 services19 patients

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.

MORGAN NICOLE GILLUM PHARMD

Pharmacist