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KROGER PHARMACY
NPI 1144254905
Pharmacy - Community/Retail Pharmacy in West Bloomfield, MI

Active since July 10, 2006CLIA 23D2077115 · Waiver
4805 HAGGERTY RD, WEST BLOOMFIELD, MI 48323(248) 960-7535(248) 960-7529 Get Directions Write a Review

NPPES record last updated: January 25, 2019. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Kroger Pharmacy NPPES

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

KROGER PHARMACY (NPI 1144254905) is a healthcare organization registered as a community/retail pharmacy in West Bloomfield, Michigan and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through April 30, 2028 and lists Jessie Warman, Manager Rx Licensing, as its authorized official.

NPPES Registry Identity

NPI1144254905
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameKROGER CO OF MICHIGAN
Location Address4805 HAGGERTY RDWest Bloomfield, MI 48323-3901
Mailing Address40399 Grand River Ave Ste 110Novi, MI 48375-2148 · (248) 536-1545 · Fax (248) 536-1599
Phone(248) 960-7535
Fax(248) 960-7529
Organization SubpartNo
Authorized OfficialJessie WarmanManager Rx Licensing · (513) 762-1090
Enumeration DateJuly 10, 2006
Last NPPES UpdateJanuary 25, 2019
✔ NPI 1144254905 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 MI · 5301006519
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
4805 HAGGERTY RD, West Bloomfield, MI 48323
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Other Names 1

Doing Business AsKroger Pharmacy

Other Identifiers 2

Medicaid3314768MI
Other2043467Pk

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 23D2077115

Kroger Co Of Michigan, The · Novi, MI
Active · expires Apr 30, 2028
CLIA Number23D2077115
Laboratory TypeRetail Pharmacy
Certificate Effective DateMay 1, 2026
Certificate Expiration DateApril 30, 2028
Laboratory DirectorRobert Brown
Laboratory Phone(248) 374-9714
Laboratory LocationKroger Co Of Michigan, The47650 Grand River Kroger Pharmacy 018-632 Attn Pharmacist In Charge, Novi, MI 48375
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

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 Co Of Michigan's NPI number?

The NPI number for Kroger Co Of Michigan is 1144254905. It was assigned to this organization in the NPPES registry on July 10, 2006. The provider is doing business as Kroger Pharmacy.

Where is Kroger Co Of Michigan located?

Kroger Co Of Michigan is located at 4805 Haggerty Rd, West Bloomfield, MI 48323. The listed phone number is (248) 960-7535.

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.

Does Kroger Co Of Michigan hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 23D2077115) is associated with this NPI, valid through April 30, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Kroger Co Of Michigan was last updated on January 25, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.