KROGER PHARMACY
NPI 1740403401
Pharmacist in Fairborn, OH

Active since April 11, 2007CLIA Certified · 2 labs
1161 E DAYTON YELLOW SPRINGS RD, FAIRBORN, OH 45324(937) 754-4427(937) 754-4578 Get Directions Write a Review

NPPES record last updated: August 22, 2020. 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 1740403401) is a healthcare organization registered as a pharmacist in Fairborn, Ohio and active in the NPI registry since April 2007. The organization holds 2 active CLIA laboratory certificates and lists Roy Klass, Pharmacy Manager, as its authorized official.

NPPES Registry Identity

NPI1740403401
Entity TypeOrganization
Primary Taxonomy183500000X
Legal Business NameKROGER PHARMACY
Location Address1161 E DAYTON YELLOW SPRINGS RDFairborn, OH 45324-6325
Mailing Address1161 E Dayton Yellow Springs RdFairborn, OH 45324-6325 · (937) 754-4427 · Fax (937) 754-4580
Fax(937) 754-4578
Organization SubpartNo
Authorized OfficialRoy KlassPharmacy Manager · (937) 754-4427
Enumeration DateApril 11, 2007
Last NPPES UpdateAugust 22, 2020
NPI 1740403401 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPharmacistPharmacy Service Providers
Taxonomy Code183500000X
License Licensed in OH · 03321850
Definition

An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care.

1161 E DAYTON YELLOW SPRINGS RD, Fairborn, OH 45324

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

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 36D2028731

Kroger Pharmacy #014838 · Fairborn, OH
Active · expires Aug 22, 2027
CLIA Number36D2028731
Laboratory TypePharmacy
Certificate Effective DateAugust 23, 2025
Certificate Expiration DateAugust 22, 2027
Laboratory DirectorMichelle Izor
Laboratory Phone(937) 318-3920
Laboratory LocationKroger Pharmacy #0148381161 E Dayton-Yellow Springs Road, Fairborn, OH 45324
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 36D1019809

Kroger Pharmacy 014-829 · Xenia, OH
Active · expires Aug 22, 2027
CLIA Number36D1019809
Laboratory TypePharmacy
Certificate Effective DateAugust 23, 2025
Certificate Expiration DateAugust 22, 2027
Laboratory DirectorMichelle Izor
Laboratory Phone(937) 754-4427
Laboratory LocationKroger Pharmacy 014-8291700 West Park Square, Xenia, OH 45385
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Medical Equipment Supplier Medicare DMEPOS 14

Medicare supplier enrollment and the product categories Kroger Pharmacy #938 carries, from the Medicare DMEPOS supplier directory.

Kroger Pharmacy #938

DMEPOS supplier · Englewood, OHOperated by Kroger Limited Partnership I

Accepts Medicare assignment

Kroger Pharmacy #938 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)20597033
Medicare Participant SinceAugust 27, 2003
Supplier Location855 Union BlvdEnglewood, OH 45322
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 12

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

Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
1161 E DAYTON YELLOW SPRINGS RD
FAIRBORN, OH 45324
Nurse Practitioner (Family)
1161 E DAYTON YELLOW SPRINGS RD
FAIRBORN, OH 45324
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
1161 E DAYTON YELLOW SPRINGS RD
FAIRBORN, OH 45324
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
1161 E DAYTON YELLOW SPRINGS RD
FAIRBORN, OH 45324
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
1161 E DAYTON YELLOW SPRINGS RD
FAIRBORN, OH 45324
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
1161 E DAYTON YELLOW SPRINGS RD
FAIRBORN, OH 45324
Nurse Practitioner (Family)
1161 E DAYTON YELLOW SPRINGS RD
FAIRBORN, OH 45324
Nurse Practitioner (Family)
1161 E DAYTON YELLOW SPRINGS RD
FAIRBORN, OH 45324

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 Pharmacy's NPI number?

The NPI number for Kroger Pharmacy is 1740403401. It was assigned to this organization in the NPPES registry on April 11, 2007.

Where is Kroger Pharmacy located?

Kroger Pharmacy is located at 1161 E Dayton Yellow Springs Rd, Fairborn, OH 45324. The listed phone number is (937) 754-4427.

What is Kroger Pharmacy's specialty?

The primary specialty registered for this NPI is Pharmacist with taxonomy code 183500000X.

Does Kroger Pharmacy accept Medicare assignment for medical equipment?

Yes. As a Medicare medical equipment supplier, Kroger Pharmacy #938 accepts Medicare assignment: the supplier accepts the Medicare-approved amount as payment in full for covered equipment and supplies.

Does Kroger Pharmacy 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.

When was this NPI record last updated?

The NPPES record for Kroger Pharmacy was last updated on August 22, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.