KROGER PHARMACY
NPI 1215188818
Pharmacy - Community/Retail Pharmacy in Fresno, CA

NPI Status: Active since October 02, 2008

Contact Information

10250 STATE HWY 6
FRESNO, CA
ZIP 77545
Phone: (713) 507-6266
Fax: (713) 422-8031

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  • Organization
  • Pharmacy
  • Community/Retail Pharmacy
  • Medicare Supplier
  • Accepts Medicare Approved Payment
  • CLIA Number: 19D2130174
  • CLIA Cert. Type: Pharmacy
  • CLIA Exp. Date: 05-02-2027

About KROGER PHARMACY

This page provides the complete NPI Profile along with additional information for Kroger Pharmacy, a provider established in Fresno, California operating as a Pharmacy, focusing in community/retail pharmacy . The healthcare provider is registered in the NPI registry with number 1215188818 assigned on October 2008. The practitioner's primary taxonomy code is 3336C0003X with license number 26082 (TX). The provider is registered as an organization and their NPI record was last updated 18 years ago. The provider's is doing business as Kroger Pharmacy. The authorized official of this NPI record is Bryon Cooley (Pharmacy Merchandiser)

NPI
1215188818
Provider Legal Name
KROGER TEXAS LP
Other Organization Name
KROGER PHARMACY
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
10250 STATE HWY 6 FRESNO, CA 77545
Location Phone
(713) 507-6266
Location Fax
(713) 422-8031
Mailing Address
PO BOX 677516 DALLAS, TX 75267
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
10-02-2008
Last Update Date
10-02-2008
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Kroger Pharmacy is a medicare supplier with PTAN 20632223 who accepts Medicare assignment for all durable medical equipment and supplies. The provider accepts the Medicare allowable as payment in full.The supplier carries the following product categories: Immunosuppressive Drugs or Nebulizer Drugs or Oral Anticancer Drugs or Oral Antiemetic Drugs or Commodes, Urinals, Bedpans or Blood Glucose Monitors/Supplies (Non-Mail Order) or Canes and/or Crutches or Walkers or Ostomy Supplies or Urological Supplies or Enteral Nutrients or Enteral Equipment and/or Supplies or Nebulizer Equipment and/or Supplies or Surgical Dressings.

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
License No.
26082
License State
TX
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.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

BRYON COOLEY

Authorized Official Title
PHARMACY MERCHANDISER
Authorized Official Phone
(713) 507-6276

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
5632066OTHER (01)NCPDP PROVIDER IDENTIFICATION NUMBER

Medical Equipment Supplier

The provider carries the following medical supplies product categories:

PTAN
20632223
Accepts Medicare Assignment
YES
Specialities List
Pharmacy.
Competitive Bidding
NO

Supplies List

  • 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
  • Canes and/or Crutches - Standard Canes, Quad Canes, Offset Canes, Standard Crutches, Forearm Crutches
  • Walkers - Standard Walkers, Wheeled Walkers, Folding Walker
  • Ostomy Supplies - Pouches, Paste, Powder, Barrier wipes
  • Urological Supplies - Catheters, Urinary collection devices
  • Enteral Nutrients - Enteral formula
  • Enteral Equipment and/or Supplies - Enteral infusion pumps, enteral nutrition supply kits
  • Nebulizer Equipment and/or Supplies - Nebulizers, Atomizers, Filters
  • Surgical Dressings - Gauze, Elastic bandages, Adhesive tape

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
19D2130174
Facility Type
Pharmacy
Certificate Effective Date
May 03, 2025
Certificate Expiration Date
May 02, 2027
Laboratory Director
ELIZABETH MCDANIEL
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Kroger Pharmacy 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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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1215188818, we treat the final digit (8) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 62. The final step is to find the difference between that total and the next multiple of ten (70 - 62 = 8).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
2
Unchanged
Pos 3
1
Doubled → 2
Pos 4
5
Unchanged
Pos 5
1
Doubled → 2
Pos 6
8
Unchanged
Pos 7
8
Doubled → 16 → 1 + 6
Pos 8
8
Unchanged
Pos 9
1
Doubled → 2
Check
8
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 1 → 2 1 → 2 8 → 16 → 7 1 → 2

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 2 + 2 + 5 + 2 + 8 + 1 + 6 + 8 + 2 + 24 = 62

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 62 is 70. The difference is the calculated check digit.

70 - 62 = 8
This NPI is valid
The calculated check digit is 8, which matches the last digit of 1215188818.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1215188818, enumerated as an "organization" on October 02, 2008.

The provider is located at 10250 STATE HWY 6 FRESNO, CA 77545 and the phone number is (713) 507-6266.

Pharmacy with taxonomy code 3336C0003X and a focus in Community/Retail Pharmacy.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.