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KROGER PHARMACY
NPI 1497828792
Pharmacy - Community/Retail Pharmacy in Henderson, TX

Active since November 16, 2006CLIA 45D1095004 · Waiver
2415 US HIGHWAY 79 S, HENDERSON, TX 75654(903) 657-8596(903) 657-1520 Get Directions Write a Review

NPPES record last updated: May 16, 2016. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Kroger Pharmacy NPPES

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

KROGER PHARMACY (NPI 1497828792) is a healthcare organization registered as a community/retail pharmacy in Henderson, Texas and active in the NPI registry since November 2006. The organization holds a CLIA Waiver certificate valid through January 29, 2027 and lists Allison Muennich, Manager Of Pharmacy Licensing, as its authorized official.

NPPES Registry Identity

NPI1497828792
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameKROGER TEXAS L P
Location Address2415 US HIGHWAY 79 SHenderson, TX 75654-4411
Mailing AddressPo Box 842772Boston, MA 02284-2772 · (513) 762-1019 · Fax (513) 762-1092
Phone(903) 657-8596
Fax(903) 657-1520
Organization SubpartNo
Authorized OfficialAllison MuennichManager Of Pharmacy Licensing · (513) 762-1019
Enumeration DateNovember 16, 2006
Last NPPES UpdateMay 16, 2016
✔ NPI 1497828792 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 · 20214
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
2415 US HIGHWAY 79 S, Henderson, TX 75654
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Other Names 1

Doing Business AsKroger Pharmacy

Other Identifiers 5

Medicare NSC1307140121
Other2096800Pk
Medicare PINP00170652
Medicare PINPH0425
Medicaid464616TX

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 45D1095004

Kroger Pharmacy 490 · Henderson, TX
Active · expires Jan 29, 2027
CLIA Number45D1095004
Laboratory TypePharmacy
Certificate Effective DateJanuary 30, 2025
Certificate Expiration DateJanuary 29, 2027
Laboratory DirectorMarla Fielder
Laboratory Phone(903) 657-8596
Laboratory LocationKroger Pharmacy 4902415 Hwy 79 South, Henderson, TX 75652
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 6

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.
187 services186 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.
168 services168 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.
32 services32 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.
32 services32 patients
Influenza vaccine, quadrivalent, preservative free, 0.5 ml dosage 90686
The quadrivalent influenza vaccine is a shot to protect you from four different flu viruses. It's preservative-free and given in a 0.5 ml dose. It helps your body build immunity to the flu, reducing your risk of getting sick.
13 services13 patients
Severe acute respiratory syndrome coronavirus 2 (covid-19) vaccine, recombinant spike protein nanoparticle, saponin-based adjuvant, preservative free, 5 mcg/0.5ml dosage, for intramuscular use 91304
The COVID-19 vaccine you'll receive is designed to protect against the virus. It contains tiny, harmless pieces of the virus's spike protein. These trigger your immune system to build a defense. The vaccine also includes a saponin-based adjuvant to enhance this response. It's given as a 0.5ml injection into a muscle.
12 services12 patients

Medical Equipment Supplier Medicare DMEPOS 14

Medicare supplier enrollment and the product categories Kroger Pharmacy # 490 carries, from the Medicare DMEPOS supplier directory.

Kroger Pharmacy # 490

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

Accepts Medicare assignment

Kroger Pharmacy # 490 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)20631143
Medicare Participant SinceDecember 31, 1999
Supplier Location2415 Us Highway 79 SHenderson, TX 75654
Phone(903) 657-8596
Supplier Specialties
Pharmacy

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 2

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

MRS. KAREN MARIE INGRAM RPH
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
2415 US HIGHWAY 79 S
HENDERSON, TX 75654
Rusk County (903) 657-8596
JANEIL PENNAL
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
2415 US HIGHWAY 79 S
HENDERSON, TX 75654
Rusk County (903) 657-8596

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 1497828792. It was assigned to this organization in the NPPES registry on November 16, 2006. The provider is doing business as Kroger Pharmacy.

Where is Kroger Texas L P located?

Kroger Texas L P is located at 2415 Us Highway 79 S, Henderson, TX 75654. The listed phone number is (903) 657-8596.

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 # 490 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 45D1095004) is associated with this NPI, valid through January 29, 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 May 16, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.