KROGER PHARMACY
NPI 1407880107
Pharmacy - Community/Retail Pharmacy in Kettering, OH

Q: What is Kroger Limited Partnership I's NPI number?

The NPI number for Kroger Limited Partnership I is 1407880107. It was assigned to this organization in the NPPES registry on July 10, 2006. The provider is doing business as Kroger Pharmacy.

Q: 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.

Active since July 10, 2006CLIA Certified · 2 labs

2115 E DOROTHY LN, KETTERING, OH 45420(937) 299-8437(937) 299-9036 Get Directions Write a Review

NPPES record last updated: February 4, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Feb 4, 2020, Aug 10, 2016, May 16, 2016 (3 updates tracked since 2016).

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About Kroger Pharmacy NPPES

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

KROGER PHARMACY (NPI 1407880107) is a healthcare organization registered as a community/retail pharmacy in Kettering, Ohio and active in the NPI registry since July 2006. The organization holds 2 active CLIA laboratory certificates and lists Jessie Warman, Manager Of Pharmacy Licensing, as its authorized official.

NPPES Registry Identity

NPI1407880107

Entity TypeOrganization

Primary Taxonomy3336C0003X

Legal Business NameKROGER LIMITED PARTNERSHIP I

Location Address2115 E DOROTHY LNKettering, OH 45420-1176

Mailing AddressPo Box 842772Boston, MA 02284-2772 · (513) 762-1019 · Fax (513) 762-1092

Phone(937) 299-8437

Fax(937) 299-9036

Organization SubpartNo

Authorized OfficialJessie WarmanManager Of Pharmacy Licensing · (513) 762-1090

Enumeration DateJuly 10, 2006

Last NPPES UpdateFebruary 4, 20203 updates tracked since enumeration

✔ NPI 1407880107 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 OH · 021051100

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

2115 E DOROTHY LN, Kettering, OH 45420

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Other Names 1

Doing Business AsKroger Pharmacy

Other Identifiers 2

Medicaid2054048OH

Other2075292Pk

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 2

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 36D1096851

Kroger Pharmacy 014-825 · Kettering, OH

Active · expires Mar 11, 2027

CLIA Number36D1096851

Laboratory TypePharmacy

Certificate Effective DateMarch 12, 2025

Certificate Expiration DateMarch 11, 2027

Laboratory DirectorMichelle Izor

Laboratory Phone(937) 299-8437

Laboratory LocationKroger Pharmacy 014-8252115 East Dorothy Lane, Kettering, OH 45420

CLIA data matches this NPI record on: Address Name Phone

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

Certificate of Waiver 36D2295081

Kroger Pharmacy #014-826 · Kettering, OH

Active · expires Dec 4, 2027

CLIA Number36D2295081

Laboratory TypePharmacy

Certificate Effective DateDecember 5, 2025

Certificate Expiration DateDecember 4, 2027

Laboratory DirectorMichelle Izor

Laboratory Phone(937) 449-0450

Laboratory LocationKroger Pharmacy #014-826530 E Stroop Rd, Kettering, OH 45429

CLIA data matches this NPI record on: Name

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.

170 services169 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.

156 services155 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.

17 services17 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

Medical Equipment Supplier Medicare DMEPOS 14

Medicare supplier enrollment and the product categories Kroger Pharmacy #14825 carries, from the Medicare DMEPOS supplier directory.

Kroger Pharmacy #14825

DMEPOS supplier · Kettering, OHOperated by Kroger Limited Partnership I

✔

Accepts Medicare assignment

Kroger Pharmacy #14825 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)20598281

Medicare Participant SinceAugust 27, 2003

Supplier Location2115 E Dorothy LnKettering, OH 45420

Phone(765) 827-5550

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.

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Other Providers at the Same Location NPPES 16

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

MRS. ERIKA VANWYCK THOMAS FNP

Nurse Practitioner (Family)