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KROGER PHARMACY
NPI 1184797615
Pharmacy - Community/Retail Pharmacy in Mesquite, TX

Active since November 15, 2006CLIA 45D2001585 · Waiver
3600 GUS THOMASSON RD, MESQUITE, TX 75150(972) 270-2401(972) 613-2465 Get Directions Write a Review

NPPES record last updated: October 26, 2018. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Oct 26, 2018, 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 1184797615) is a healthcare organization registered as a community/retail pharmacy in Mesquite, Texas and active in the NPI registry since November 2006. The organization holds a CLIA Waiver certificate valid through December 21, 2027 and lists Jessie Warman, Manager Of Pharmacy Licensing, as its authorized official.

NPPES Registry Identity

NPI1184797615
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameKROGER TEXAS L P
Location Address3600 GUS THOMASSON RDMesquite, TX 75150-6200
Mailing AddressPo Box 842772Boston, MA 02284-2772 · (513) 762-1019 · Fax (513) 762-1092
Phone(972) 270-2401
Fax(972) 613-2465
Organization SubpartNo
Authorized OfficialJessie WarmanManager Of Pharmacy Licensing · (513) 762-1019
Enumeration DateNovember 15, 2006
Last NPPES UpdateOctober 26, 20182 updates tracked since enumeration
✔ NPI 1184797615 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 TX · 20134
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
3600 GUS THOMASSON RD, Mesquite, TX 75150
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Other Names 1

Doing Business AsKroger Pharmacy

Other Identifiers 2

Other2103632Pk
Medicaid464607TX

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 45D2001585

Kroger Pharmacy 450 · Mesquite, TX
Active · expires Dec 21, 2027
CLIA Number45D2001585
Laboratory TypePharmacy
Certificate Effective DateDecember 22, 2025
Certificate Expiration DateDecember 21, 2027
Laboratory DirectorJeff Loesch
Laboratory Phone(972) 270-2401
Laboratory LocationKroger Pharmacy 4503600 Gus Thomasson Road, Mesquite, TX 75150
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.
84 services84 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.
75 services75 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.
13 services13 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.
13 services13 patients

Medical Equipment Supplier Medicare DMEPOS 14

Medicare supplier enrollment and the product categories Kroger Pharmacy #450 carries, from the Medicare DMEPOS supplier directory.

Kroger Pharmacy #450

DMEPOS supplier · Mesquite, TXOperated by Kroger Texas L P
✔

Accepts Medicare assignment

Kroger Pharmacy #450 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)20632091
Medicare Participant SinceDecember 31, 1999
Supplier Location3600 Gus Thomasson RdMesquite, TX 75150
Phone(972) 270-2401
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 7

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

JUSTIN CLIVE PERISH, D C
Chiropractor
3600 GUS THOMASSON RD, STE 146
MESQUITE, TX 75150
Dallas County (972) 698-8933
DR. SARAH LYNN CANTRELL DDS
Dentist (General Practice)
3600 GUS THOMASSON RD, STE. #127
MESQUITE, TX 75150
Dallas County (214) 275-4720
AMERISMILES DENTAL OF MESQUITE PLLC
Dentist (General Practice)
3600 GUS THOMASSON RD, SUITE # 145
MESQUITE, TX 75150
Dallas County (214) 827-1305
MARGARET M PERISH
Clinic/Center
3600 GUS THOMASSON RD, SUITE 146
MESQUITE, TX 75150
Dallas County (972) 832-1192
KROGER
Pharmacist
3600 GUS THOMASSON RD
MESQUITE, TX 75150
Dallas County (972) 270-2401
JENNIFER TONG
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
3600 GUS THOMASSON RD
MESQUITE, TX 75150
Dallas County (972) 270-2401
JENNIFER HOANG
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
3600 GUS THOMASSON RD
MESQUITE, TX 75150
Dallas County (972) 270-2401

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 Texas L P's NPI number?

The NPI number for Kroger Texas L P is 1184797615. It was assigned to this organization in the NPPES registry on November 15, 2006. The provider is doing business as Kroger Pharmacy.

Where is Kroger Texas L P located?

Kroger Texas L P is located at 3600 Gus Thomasson Rd, Mesquite, TX 75150. The listed phone number is (972) 270-2401.

What is Kroger Texas L P's specialty?

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

Does Kroger Texas L P accept Medicare assignment for medical equipment?

Yes. As a Medicare medical equipment supplier, Kroger Pharmacy #450 accepts Medicare assignment: the supplier accepts the Medicare-approved amount as payment in full for covered equipment and supplies.

Does Kroger Texas L P hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 45D2001585) is associated with this NPI, valid through December 21, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Kroger Texas L P 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 49 other insurers list Kroger Texas L P 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 Texas L P was last updated on October 26, 2018. NPI Profile syncs with the weekly NPPES data releases published by CMS.