KROGER PHARMACY
NPI 1447284294
Pharmacy - Community/Retail Pharmacy in Shelby Township, MI

Q: What is Kroger Co Of Michigan's NPI number?

The NPI number for Kroger Co Of Michigan is 1447284294. 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 Co Of Michigan'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 23D2077132 · Waiver

2058 25 MILE RD, SHELBY TOWNSHIP, MI 48316(248) 651-9752(248) 651-1678 Get Directions Write a Review

NPPES record last updated: January 16, 2019. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jan 16, 2019, May 16, 2016 (2 updates tracked since 2016).

On this page

About Kroger Pharmacy NPPES

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

KROGER PHARMACY (NPI 1447284294) is a healthcare organization registered as a community/retail pharmacy in Shelby Township, Michigan and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through April 30, 2028 and lists Jessie Warman, Manager Rx Licensing, as its authorized official.

NPPES Registry Identity

NPI1447284294

Entity TypeOrganization

Primary Taxonomy3336C0003X

Legal Business NameKROGER CO OF MICHIGAN

Location Address2058 25 MILE RDShelby Township, MI 48316-1096

Mailing AddressPo Box 842772Boston, MA 02284-2772 · (513) 762-1090

Phone(248) 651-9752

Fax(248) 651-1678

Organization SubpartNo

Authorized OfficialJessie WarmanManager Rx Licensing · (513) 762-1090

Enumeration DateJuly 10, 2006

Last NPPES UpdateJanuary 16, 20192 updates tracked since enumeration

✔ NPI 1447284294 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 MI · 5301007356

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

2058 25 MILE RD, Shelby Township, MI 48316

Open in Google Maps ↗

Other Names 1

Doing Business AsKroger Pharmacy

Other Identifiers 2

Other2044877Pk

Medicaid2362351MI

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 23D2077132

Kroger Co Of Michigan, The · Shelby Township, MI

Active · expires Apr 30, 2028

CLIA Number23D2077132

Laboratory TypeRetail Pharmacy

Certificate Effective DateMay 1, 2026

Certificate Expiration DateApril 30, 2028

Laboratory DirectorRobert Brown

Laboratory Phone(248) 651-9752

Laboratory LocationKroger Co Of Michigan, The2058 25 Mile Road Kroger Pharmacy 018-704 Attn Pharmacist In Charge, Shelby Township, MI 48316

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.

197 services194 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.

189 services186 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.

26 services26 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.

26 services26 patients

Medical Equipment Supplier Medicare DMEPOS 14

Medicare supplier enrollment and the product categories Kroger Pharmacy 704 carries, from the Medicare DMEPOS supplier directory.

Kroger Pharmacy 704

DMEPOS supplier · Shelby Township, MIOperated by Kroger Co Of Michigan

✔

Accepts Medicare assignment

Kroger Pharmacy 704 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)20410997

Medicare Participant SinceNovember 5, 2020

Supplier Location2058 25 Mile RdShelby Township, MI 48316

Phone(248) 651-9752

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 5

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

FADI FRANCIS

Pharmacist