KROGER PHARMACY
NPI 1629002357
Pharmacy - Community/Retail Pharmacy in Cordova, TN

Q: What is the provider's specialty?

The provider's specialty is Pharmacy with taxonomy code 3336C0003X and a focus in Community/Retail Pharmacy.

Active since July 10, 2006CLIA Certified · 3 labs

676 N GERMANTOWN PKWY, CORDOVA, TN 38018(901) 756-1138(901) 758-3610 Get Directions Write a Review

NPPES record last updated: March 13, 2020. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Mar 13, 2020, Sep 15, 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 1629002357) is a healthcare organization registered as a community/retail pharmacy in Cordova, Tennessee and active in the NPI registry since July 2006. The organization holds 3 active CLIA laboratory certificates and lists Jessie Warman, Manager Of Pharmacy Licensing, as its authorized official.

NPPES Registry Identity

NPI1629002357

Entity TypeOrganization

Primary Taxonomy3336C0003X

Legal Business NameKROGER LIMITED PARTNERSHIP I

Location Address676 N GERMANTOWN PKWYCordova, TN 38018-6210

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

Phone(901) 756-1138

Fax(901) 758-3610

Organization SubpartNo

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

Enumeration DateJuly 10, 2006

Last NPPES UpdateMarch 13, 20203 updates tracked since enumeration

NPPES CertifiedMarch 13, 2020

✔ NPI 1629002357 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 TN · C1875

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

676 N GERMANTOWN PKWY, Cordova, TN 38018

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Other Names 1

Doing Business AsKroger Pharmacy

Other Identifiers 2

Medicaid9449402TN

Other2090602Pk

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 3

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 44D1009238

Kroger Pharmacy #410 · Cordova, TN

Active · expires Feb 9, 2027

CLIA Number44D1009238

Laboratory TypePharmacy

Certificate Effective DateFebruary 10, 2025

Certificate Expiration DateFebruary 9, 2027

Laboratory DirectorCynthia Fisher

Laboratory Phone(901) 756-1138

Laboratory LocationKroger Pharmacy #410676 Germantown Parkway, Cordova, TN 38018

CLIA data matches this NPI record on: Name Phone

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

Certificate of Waiver 44D1011003

Kroger Pharmacy #457 · Cordova, TN

Active · expires Mar 30, 2027

CLIA Number44D1011003

Laboratory TypePharmacy

Certificate Effective DateMarch 31, 2025

Certificate Expiration DateMarch 30, 2027

Laboratory DirectorCynthia Fisher

Laboratory Phone(901) 751-1615

Laboratory LocationKroger Pharmacy #4571230 N Houston Levee Road, Cordova, TN 38018

CLIA data matches this NPI record on: Name

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

Certificate of Waiver 44D1009263

Kroger Pharmacy #426 · Cordova, TN

Active · expires Feb 10, 2027

CLIA Number44D1009263

Laboratory TypePharmacy

Certificate Effective DateFebruary 11, 2025

Certificate Expiration DateFebruary 10, 2027

Laboratory DirectorCynthia Fisher

Laboratory Phone(901) 624-9637

Laboratory LocationKroger Pharmacy #4261675 Germantown Parkway, Cordova, TN 38018

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.

186 services184 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.

175 services173 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.

20 services20 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

Other Providers at the Same Location NPPES 20

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

CHRISTINA BETH DRUMMOND PHARM D

Pharmacist