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KROGER PHARMACY
NPI 1376577155
Pharmacy - Community/Retail Pharmacy in Poplar Bluff, MO

Active since July 10, 2006CLIA 26D1022367 · Waiver
2770 N WESTWOOD BLVD, POPLAR BLUFF, MO 63901(573) 686-6974(573) 686-6975 Get Directions Write a Review

NPPES record last updated: March 13, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Mar 13, 2020, 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 1376577155) is a healthcare organization registered as a community/retail pharmacy in Poplar Bluff, Missouri and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through February 12, 2028 and lists Jessie Warman, Manager Of Pharmacy Licensing, as its authorized official.

NPPES Registry Identity

NPI1376577155
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameKROGER LIMITED PARTNERSHIP I
Location Address2770 N WESTWOOD BLVDPoplar Bluff, MO 63901-2345
Mailing AddressPo Box 842772Boston, MA 02284-2772 · (513) 762-1019 · Fax (513) 762-1092
Phone(573) 686-6974
Fax(573) 686-6975
Organization SubpartNo
Authorized OfficialJessie WarmanManager Of Pharmacy Licensing · (513) 762-1090
Enumeration DateJuly 10, 2006
Last NPPES UpdateMarch 13, 20202 updates tracked since enumeration
NPPES CertifiedMarch 13, 2020
✔ NPI 1376577155 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 MO · PS004006
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
2770 N WESTWOOD BLVD, Poplar Bluff, MO 63901
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Other Names 1

Doing Business AsKroger Pharmacy

Other Identifiers 2

Medicaid600130785MO
Other2050246Pk

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 26D1022367

Kroger Pharmacy #386 · Poplar Bluff, MO
Active · expires Feb 12, 2028
CLIA Number26D1022367
Laboratory TypePharmacy
Certificate Effective DateFebruary 13, 2026
Certificate Expiration DateFebruary 12, 2028
Laboratory DirectorCynthia Fisher
Laboratory Phone(573) 686-6974
Laboratory LocationKroger Pharmacy #3862770 North Westwood, Poplar Bluff, MO 63901
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.
220 services219 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.
208 services207 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.
17 services17 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.
15 services15 patients

Medical Equipment Supplier Medicare DMEPOS 14

Medicare supplier enrollment and the product categories Kroger Pharmacy #386 carries, from the Medicare DMEPOS supplier directory.

Kroger Pharmacy #386

DMEPOS supplier · Poplar Bluff, MOOperated by Kroger Limited Partnership I
✔

Accepts Medicare assignment

Kroger Pharmacy #386 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)20597663
Medicare Participant SinceAugust 27, 2003
Supplier Location2770 N Westwood BlvdPoplar Bluff, MO 63901
Phone(573) 686-6974
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 3

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

MALARIE BLACKWELL PHARMD
Pharmacist
2770 N WESTWOOD BLVD
POPLAR BLUFF, MO 63901
Butler County (573) 686-6974
DR. CHRISTINA DUNIVAN PHARMD
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
2770 N WESTWOOD BLVD
POPLAR BLUFF, MO 63901
Butler County (573) 686-6974
BREANNA GOOSTREE PHARMD
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
2770 N WESTWOOD BLVD
POPLAR BLUFF, MO 63901
Butler County (573) 686-6974

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 Limited Partnership I's NPI number?

The NPI number for Kroger Limited Partnership I is 1376577155. 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 Limited Partnership I located?

Kroger Limited Partnership I is located at 2770 N Westwood Blvd, Poplar Bluff, MO 63901. The listed phone number is (573) 686-6974.

What is Kroger Limited Partnership I's specialty?

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

Does Kroger Limited Partnership I accept Medicare assignment for medical equipment?

Yes. As a Medicare medical equipment supplier, Kroger Pharmacy #386 accepts Medicare assignment: the supplier accepts the Medicare-approved amount as payment in full for covered equipment and supplies.

Does Kroger Limited Partnership I hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 26D1022367) is associated with this NPI, valid through February 12, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Kroger Limited Partnership I 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 47 other insurers list Kroger Limited Partnership I 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 Limited Partnership I was last updated on March 13, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.