KROGER CO
NPI 1154294205
Pharmacy - Community/Retail Pharmacy in Bethlehem, GA

Q: What is Kroger Co's NPI number?

The NPI number for Kroger Co is 1154294205. It was assigned to this organization in the NPPES registry on September 25, 2025. The provider is doing business as Kroger Drugstore #622.

Q: What is Kroger Co's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

Q: When was this NPI record last updated?

The NPPES record for Kroger Co was last updated on September 25, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months 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.

Active since September 25, 2025CLIA 11D2332487 · Waiver

995 LOGANVILLE HIGHWAY, BETHLEHEM, GA 30620(470) 900-2960(470) 900-2961 Get Directions Write a Review

NPPES record last updated: September 25, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Kroger Co NPPES

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

KROGER CO (NPI 1154294205), doing business as Kroger Drugstore #622, is a healthcare organization registered as a community/retail pharmacy in Bethlehem, Georgia and active in the NPI registry since September 2025. The organization holds a CLIA Waiver certificate valid through October 20, 2027 and lists Lysette Seilhamer, Manager Of Licensing, as its authorized official.

NPPES Registry Identity

NPI1154294205

Entity TypeOrganization

Primary Taxonomy3336C0003X

Legal Business NameKROGER CO

Location Address995 LOGANVILLE HIGHWAYBethlehem, GA 30620

Mailing AddressPo Box 830242Philadelphia, PA 19183-0352

Phone(470) 900-2960

Fax(470) 900-2961

Organization SubpartNo

Authorized OfficialLysette SeilhamerManager Of Licensing · (513) 762-1090

Enumeration DateSeptember 25, 2025

NPPES CertifiedSeptember 11, 2025

✔ NPI 1154294205 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers

Taxonomy Code3336C0003X

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

995 LOGANVILLE HIGHWAY, Bethlehem, GA 30620

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Other Names 1

Doing Business AsKroger Drugstore #622

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 11D2332487

Kroger Pharmacy 01100622 · Bethlehem, GA

Active · expires Oct 20, 2027

CLIA Number11D2332487

Laboratory TypePharmacy

Certificate Effective DateOctober 21, 2025

Certificate Expiration DateOctober 20, 2027

Laboratory DirectorChuck Page

Laboratory Phone(470) 900-2960

Laboratory LocationKroger Pharmacy 01100622995 Loganville Highway, Bethlehem, GA 30620

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

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

DR. LUCINDA A DIXON PHARMD

Pharmacist

995 LOGANVILLE HIGHWAY
BETHLEHEM, GA 30620

Barrow County (470) 900-2960

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's NPI number?

The NPI number for Kroger Co is 1154294205. It was assigned to this organization in the NPPES registry on September 25, 2025. The provider is doing business as Kroger Drugstore #622.

Where is Kroger Co located?

Kroger Co is located at 995 Loganville Highway, Bethlehem, GA 30620. The listed phone number is (470) 900-2960.

What is Kroger Co's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

Does Kroger Co hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D2332487) is associated with this NPI, valid through October 20, 2027. 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 was last updated on September 25, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months 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.