KROGER PHARMACY #743
NPI 1750837670
Pharmacy - Community/Retail Pharmacy in Royal Oak, MI

Q: What is Kroger Co Of Michigan's NPI number?

The NPI number for Kroger Co Of Michigan is 1750837670. It was assigned to this organization in the NPPES registry on August 31, 2016. The provider is doing business as Kroger Pharmacy #743.

Q: What is Kroger Co Of Michigan's specialty?

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

Active since August 31, 2016CLIA 23D2128396 · Waiver

2200 E 12 MILE RD, ROYAL OAK, MI 48067(248) 397-1530(248) 397-1532 Get Directions Write a Review

NPPES record last updated: January 17, 2017. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jan 17, 2017, Nov 22, 2016, Nov 16, 2016 and 2 more (5 updates tracked since 2016).

On this page

About Kroger Pharmacy #743 NPPES

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

KROGER PHARMACY #743 (NPI 1750837670) is a healthcare organization registered as a community/retail pharmacy in Royal Oak, Michigan and active in the NPI registry since August 2016. The organization holds a CLIA Waiver certificate valid through March 28, 2027 and lists Allison Bredestege, Manager Of Pharmacy Licensing, as its authorized official.

NPPES Registry Identity

NPI1750837670

Entity TypeOrganization

Primary Taxonomy3336C0003X

Legal Business NameKROGER CO OF MICHIGAN

Location Address2200 E 12 MILE RDRoyal Oak, MI 48067-1504

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

Phone(248) 397-1530

Fax(248) 397-1532

Organization SubpartNo

Authorized OfficialAllison BredestegeManager Of Pharmacy Licensing · (513) 762-1263

Enumeration DateAugust 31, 2016

Last NPPES UpdateJanuary 17, 20175 updates tracked since enumeration

✔ NPI 1750837670 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 MI · 5301011042

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

2200 E 12 MILE RD, Royal Oak, MI 48067

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Other Names 1

Doing Business AsKroger Pharmacy #743

Other Identifiers 4

Medicaid1750837670MI

Other2163907Pk

Medicare NSC2663030110

Medicare PIN0P02440

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 23D2128396

Kroger Pharmacy · Royal Oak, MI

Active · expires Mar 28, 2027

CLIA Number23D2128396

Laboratory TypePharmacy

Certificate Effective DateMarch 29, 2025

Certificate Expiration DateMarch 28, 2027

Laboratory DirectorRobert Brown

Laboratory Phone(248) 397-1530

Laboratory LocationKroger Pharmacy2200 East 12 Mile Road Kroger Pharmacy 018-743 Attn Pharmacist In Charge, Royal Oak, MI 48067

CLIA data matches this NPI record on: Address Name Phone

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.

149 services149 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.

136 services136 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.

40 services39 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.

30 services30 patients

Medical Equipment Supplier Medicare DMEPOS 14

Medicare supplier enrollment and the product categories Kroger Pharmacy #743 carries, from the Medicare DMEPOS supplier directory.

Kroger Pharmacy #743

DMEPOS supplier · Royal Oak, MIOperated by Kroger Co Of Michigan

✔

Accepts Medicare assignment

Kroger Pharmacy #743 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)20410385

Medicare Participant SinceNovember 5, 2020

Supplier Location2200 E 12 Mile RdRoyal Oak, MI 48067

Phone(248) 397-1530

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.

ARIEG YALDA

Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)

2200 E 12 MILE RD
ROYAL OAK, MI 48067

Oakland County (248) 397-1530

MICHELLE POSA

Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)

2200 E 12 MILE RD
ROYAL OAK, MI 48067

Oakland County (248) 397-1530

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 Co Of Michigan's NPI number?

The NPI number for Kroger Co Of Michigan is 1750837670. It was assigned to this organization in the NPPES registry on August 31, 2016. The provider is doing business as Kroger Pharmacy #743.

Where is Kroger Co Of Michigan located?

Kroger Co Of Michigan is located at 2200 E 12 Mile Rd, Royal Oak, MI 48067. The listed phone number is (248) 397-1530.

What is Kroger Co Of Michigan's specialty?

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

Does Kroger Co Of Michigan accept Medicare assignment for medical equipment?

Yes. As a Medicare medical equipment supplier, Kroger Pharmacy #743 accepts Medicare assignment: the supplier accepts the Medicare-approved amount as payment in full for covered equipment and supplies.

Does Kroger Co Of Michigan hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 23D2128396) is associated with this NPI, valid through March 28, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Kroger Co Of Michigan 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 47 other insurers list Kroger Co Of Michigan 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 Co Of Michigan was last updated on January 17, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.