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KROGER PHARMACY #03500565
NPI 1649753476
Pharmacy - Community/Retail Pharmacy in Mckinney, TX

Active since September 07, 2018CLIA 45D2161094 · Waiver
1801 N LAKE FOREST DR, MCKINNEY, TX 75071(513) 762-1019 Get Directions Write a Review

NPPES record last updated: January 24, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jan 24, 2019, Sep 10, 2018, Sep 7, 2018 (3 updates tracked since 2018).

About Kroger Pharmacy #03500565 NPPES

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

KROGER PHARMACY #03500565 (NPI 1649753476) is a healthcare organization registered as a community/retail pharmacy in Mckinney, Texas and active in the NPI registry since September 2018. The organization holds a CLIA Waiver certificate valid through January 24, 2027 and lists Jessie Warman, Manager Of Licensing, as its authorized official.

NPPES Registry Identity

NPI1649753476
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameKROGER TEXAS LP
Location Address1801 N LAKE FOREST DRMckinney, TX 75071-7602
Mailing AddressPo Box 842440Boston, MA 02284-2440
Phone(513) 762-1019
Organization SubpartNo
Authorized OfficialJessie WarmanManager Of Licensing · (513) 762-1019
Enumeration DateSeptember 7, 2018
Last NPPES UpdateJanuary 24, 20193 updates tracked since enumeration
✔ NPI 1649753476 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
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
1801 N LAKE FOREST DR, Mckinney, TX 75071
Open in Google Maps ↗

Other Names 1

Doing Business AsKroger Pharmacy #03500565

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 45D2161094

Kroger Pharmacy #035-565 · Mckinney, TX
Active · expires Jan 24, 2027
CLIA Number45D2161094
Laboratory TypePharmacy
Certificate Effective DateJanuary 25, 2025
Certificate Expiration DateJanuary 24, 2027
Laboratory DirectorJeff Loesch
Laboratory Phone(469) 678-3839
Laboratory LocationKroger Pharmacy #035-5651801 N Lake Forest Dr, Mckinney, TX 75071
CLIA data matches this NPI record on: Address
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.
195 services195 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.
180 services180 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.
20 services20 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

Medical Equipment Supplier Medicare DMEPOS 14

Medicare supplier enrollment and the product categories Kroger Pharmacy 03500565 carries, from the Medicare DMEPOS supplier directory.

Kroger Pharmacy 03500565

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

Accepts Medicare assignment

Kroger Pharmacy 03500565 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)20631521
Medicare Participant SinceDecember 31, 1999
Supplier Location1801 N Lake Forest DrMckinney, TX 75071
Phone(469) 678-3882
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 4

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

ALEXANDRA BROWER PHARM D.
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
1801 N LAKE FOREST DR
MCKINNEY, TX 75071
Collin County (469) 678-3882
ALESHA ERICKSON RPH
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
1801 N LAKE FOREST DR
MCKINNEY, TX 75071
Collin County (469) 678-3882
MAI-LIEN TRUONG PHARMD
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
1801 N LAKE FOREST DR
MCKINNEY, TX 75071
Collin County (469) 678-3882
SHALA DEVLIN PHARMD, RPH
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
1801 N LAKE FOREST DR
MCKINNEY, TX 75071
Collin County (469) 678-3882

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 LP's NPI number?

The NPI number for Kroger Texas LP is 1649753476. It was assigned to this organization in the NPPES registry on September 7, 2018. The provider is doing business as Kroger Pharmacy #03500565.

Where is Kroger Texas LP located?

Kroger Texas LP is located at 1801 N Lake Forest Dr, Mckinney, TX 75071. The listed phone number is (513) 762-1019.

What is Kroger Texas LP's specialty?

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

Does Kroger Texas LP accept Medicare assignment for medical equipment?

Yes. As a Medicare medical equipment supplier, Kroger Pharmacy 03500565 accepts Medicare assignment: the supplier accepts the Medicare-approved amount as payment in full for covered equipment and supplies.

Does Kroger Texas LP hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 45D2161094) is associated with this NPI, valid through January 24, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Kroger Texas LP 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 LP 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 LP was last updated on January 24, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.