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KROGER PHARMACY
NPI 1740353358
Pharmacy - Community/Retail Pharmacy in Mansfield, TX

Active since November 15, 2006CLIA Certified · 2 labs
3001 MATLOCK RD, MANSFIELD, TX 76063(817) 473-0081(817) 472-0972 Get Directions Write a Review

NPPES record last updated: May 16, 2016. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Kroger Pharmacy NPPES

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

KROGER PHARMACY (NPI 1740353358) is a healthcare organization registered as a community/retail pharmacy in Mansfield, Texas and active in the NPI registry since November 2006. The organization holds 2 active CLIA laboratory certificates and lists Allison Muennich, Manager Of Pharmacy Licensing, as its authorized official.

NPPES Registry Identity

NPI1740353358
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameKROGER TEXAS L P
Location Address3001 MATLOCK RDMansfield, TX 76063-3302
Mailing AddressPo Box 842772Boston, MA 02284-2772 · (513) 762-1019 · Fax (513) 762-1092
Phone(817) 473-0081
Fax(817) 472-0972
Organization SubpartNo
Authorized OfficialAllison MuennichManager Of Pharmacy Licensing · (513) 762-1019
Enumeration DateNovember 15, 2006
Last NPPES UpdateMay 16, 2016
✔ NPI 1740353358 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 · 20213
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
3001 MATLOCK RD, Mansfield, TX 76063
Open in Google Maps ↗

Other Names 1

Doing Business AsKroger Pharmacy

Other Identifiers 5

Medicare PINP00170648
Medicare PINPH0430
Other2096799Pk
Medicaid464615TX
Medicare NSC1307140082

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 45D1067624

Kroger Pharmacy 584 · Mansfield, TX
Active · expires Apr 22, 2027
CLIA Number45D1067624
Laboratory TypePharmacy
Certificate Effective DateApril 23, 2025
Certificate Expiration DateApril 22, 2027
Laboratory DirectorJeff Loesch
Laboratory Phone(817) 473-0081
Laboratory LocationKroger Pharmacy 5843001 Matlock, Mansfield, TX 76063
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 45D2034923

Kroger Pharmacy # 594 · Mansfield, TX
Active · expires Jan 5, 2028
CLIA Number45D2034923
Laboratory TypeRetail Pharmacy
Certificate Effective DateJanuary 6, 2026
Certificate Expiration DateJanuary 5, 2028
Laboratory DirectorJeff Loesch
Laboratory Phone(469) 888-5519
Laboratory LocationKroger Pharmacy # 5943300 East Broad Street, Mansfield, TX 76063
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.
99 services99 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.
94 services94 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.
14 services14 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.
14 services14 patients

Medical Equipment Supplier Medicare DMEPOS 14

Medicare supplier enrollment and the product categories Kroger Pharamacy #584 carries, from the Medicare DMEPOS supplier directory.

Kroger Pharamacy #584

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

Accepts Medicare assignment

Kroger Pharamacy #584 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)20631191
Medicare Participant SinceDecember 31, 1999
Supplier Location3001 Matlock RdMansfield, TX 76063
Phone(817) 473-0081
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.

JAMIE FOLK
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
3001 MATLOCK RD
MANSFIELD, TX 76063
Tarrant County (817) 473-0081
MAI THANH KIM PHARMD
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
3001 MATLOCK RD
MANSFIELD, TX 76063
Tarrant County (817) 473-0081

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 1740353358. It was assigned to this organization in the NPPES registry on November 15, 2006. The provider is doing business as Kroger Pharmacy.

Where is Kroger Texas L P located?

Kroger Texas L P is located at 3001 Matlock Rd, Mansfield, TX 76063. The listed phone number is (817) 473-0081.

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 Pharamacy #584 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 CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

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 with the weekly NPPES data releases published by CMS.