KROGER CO
NPI 1154294205
Pharmacy - Community/Retail Pharmacy in Bethlehem, GA
- Organization
- Pharmacy
- Community/Retail Pharmacy
- CLIA Number: 11D2332487
- CLIA Cert. Type: Pharmacy
- CLIA Exp. Date: 10-20-2027
About KROGER CO
This page provides the complete NPI Profile along with additional information for Kroger Co, a provider established in Bethlehem, Georgia operating as a Pharmacy, focusing in community/retail pharmacy . The healthcare provider is registered in the NPI registry with number 1154294205 assigned on September 2025. The practitioner's primary taxonomy code is 3336C0003X. The provider is registered as an organization and their NPI record was last updated one year ago. The authorized official of this NPI record is Lysette Seilhamer (Manager Of Licensing)
- NPI
- 1154294205 Verify this NPI
- Provider Name
- KROGER CO
- Entity Type
- Organization
- Location Address
- 995 LOGANVILLE HIGHWAY BETHLEHEM, GA 30620
- Location Phone
- (470) 900-2960
- Location Fax
- (470) 900-2961
- Mailing Address
- PO BOX 830242 PHILADELPHIA, PA 19183
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 09-25-2025
- Last Update Date
- 09-25-2025
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Pharmacy Community/Retail Pharmacy
- Taxonomy Code
- 3336C0003X
- Type
- Suppliers
- Taxonomy Description
- 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.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 332B00000X | Suppliers | Durable Medical Equipment & Medical Supplies |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 11D2332487
- Facility Type
- Pharmacy
- Certificate Effective Date
- October 21, 2025
- Certificate Expiration Date
- October 20, 2027
- Laboratory Director
- CHUCK PAGE
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Kroger Co to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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Other Providers at the Same Location
The following 1 provider is registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1154294205, enumerated as an "organization" on September 25, 2025.
The provider is located at 995 LOGANVILLE HIGHWAY BETHLEHEM, GA 30620 and the phone number is (470) 900-2960.
Pharmacy with taxonomy code 3336C0003X and a focus in Community/Retail Pharmacy.
