THE KROGER CO
NPI 1780134403
Pharmacy - Community/Retail Pharmacy in Atlanta, GA

NPI Status: Active since October 05, 2016

Contact Information

2452 MOROSGO WAY NE
ATLANTA, GA
ZIP 30324
Phone: (404) 946-0450
Fax: (404) 946-0451

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  • Organization
  • Pharmacy
  • Community/Retail Pharmacy
  • Accepts Insurance
  • Medicare Supplier
  • Accepts Medicare Approved Payment
  • CLIA Number: 11D2121170
  • CLIA Cert. Type: Other - RETAIL PHARMACY
  • CLIA Exp. Date: 10-31-2026

About THE KROGER CO

This page provides the complete NPI Profile along with additional information for The Kroger Co, a provider established in Atlanta, Georgia operating as a Pharmacy, focusing in community/retail pharmacy . The healthcare provider is registered in the NPI registry with number 1780134403 assigned on October 2016. The practitioner's primary taxonomy code is 3336C0003X with license number PHRE010314 (GA). The provider is registered as an organization and their NPI record was last updated one year ago. The provider's . The authorized official of this NPI record is Jessie Warman (Manager Of Pharmacy Licensing)

NPI
1780134403
Provider Legal Name
THE KROGER CO
Other Organization Name
Other Name Type
(6)
Entity Type
Organization
Location Address
2452 MOROSGO WAY NE ATLANTA, GA 30324
Location Phone
(404) 946-0450
Location Fax
(404) 946-0451
Mailing Address
PO BOX 842772 BOSTON, MA 02284
Mailing Phone
(513) 762-1019
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
10-05-2016
Last Update Date
04-21-2025
Code Navigator



The Kroger Co is a medicare supplier with PTAN 20304233 who accepts Medicare assignment for all durable medical equipment and supplies. The provider accepts the Medicare allowable as payment in full.The supplier carries the following product categories: Immunosuppressive Drugs or Nebulizer Drugs or Oral Anticancer Drugs or Oral Antiemetic Drugs or Commodes, Urinals, Bedpans or Blood Glucose Monitors/Supplies (Non-Mail Order) or Canes and/or Crutches or Walkers or Ostomy Supplies or Urological Supplies or Enteral Nutrients or Enteral Equipment and/or Supplies or Nebulizer Equipment and/or Supplies or Surgical Dressings.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Pharmacy Community/Retail Pharmacy

Taxonomy Code
3336C0003X
Type
Suppliers
License No.
PHRE010314
License State
GA
Taxonomy Description
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.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1332B00000XSuppliers

Durable Medical Equipment & Medical Supplies

 
2333600000XSuppliers

Pharmacy

 

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • AvMed Entrust Bronze 600 (2026) - HMO
  • AvMed Entrust Bronze 650 (2026) - HMO
  • AvMed Entrust Expanded Bronze Standard (2026) - HMO
  • AvMed Entrust Gold 125 (2026) - HMO
  • AvMed Entrust Gold 125 Dental+Vision (2026) - HMO
  • AvMed Entrust Gold Standard (2026) - HMO
  • AvMed Entrust Platinum 25 (2026) - HMO
  • AvMed Entrust Platinum 25 Dental+Vision (2026) - HMO
  • AvMed Entrust Platinum Standard (2026) - HMO
  • AvMed Entrust Silver 350 (2026) - HMO
  • Humana Dental Smart Choice - PPO
  • Humana Dental Smart Choice - High - PPO
  • Humana Dental Smart Choice - Lite - PPO
  • Humana Dental Smart Choice - Low - PPO
  • Select by Medica Bronze $0 Copay PCP Visits - EPO
  • Select by Medica Bronze Share - EPO
  • Select by Medica Expanded Bronze Standard - EPO
  • Select by Medica Gold $0 Copay PCP Visits - EPO
  • Select by Medica Gold Share - EPO
  • Select by Medica Gold Standard - EPO
  • Select by Medica Silver $0 Copay PCP Visits - EPO
  • Select by Medica Silver Share - EPO
  • Select by Medica Silver Standard - EPO
  • MENDING Direct Primary Care Bronze 4950 ($0 DPC + $0 PCP + $0 Mental Health) - HMO
  • MENDING Direct Primary Care Gold $0 Ded ($0 DPC $0 PCP + $0 Mental Health) - HMO
  • MENDING Direct Primary Care Silver 2300 ($0 DPC + $0 PCP + $0 Mental Health) - HMO
  • MENDING Standard Bronze (No Direct Primary Care, for DPC select DPC Bronze) - HMO
  • MENDING Standard Gold (No Direct Primary Care, for DPC select DPC Gold) - HMO
  • MENDING Standard Silver (No Direct Primary Care, for DPC select DPC Silver) - HMO
  • Moda Health Affinity Bronze 8000 - EPO
  • Moda Health Affinity Bronze 9000 - EPO
  • Moda Health Affinity Bronze HDHP 7500 - EPO
  • Moda Health Affinity Gold 1000 - EPO
  • Moda Health Affinity Gold 1500 - EPO
  • Moda Health Affinity Gold 250 - EPO
  • Moda Health Affinity Silver 3000 - EPO
  • Moda Health Affinity Silver 3400 - EPO
  • Moda Health Affinity Silver 4500 - EPO
  • Moda Health Affinity Silver 6000 - EPO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

JESSIE WARMAN

Authorized Official Title
MANAGER OF PHARMACY LICENSING
Authorized Official Phone
(513) 762-1263

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
003181373AMEDICAID (05)GA 
2164511OTHER (01)PK

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Adm sarscov2 50mcg/0.25mlbst

This procedure involves administering a dose of a SARS-CoV-2 vaccine. The specific dosage is 50 micrograms in a 0.25 milliliter booster shot. This vaccine helps your body build immunity against the COVID-19 virus. It's a key part of global efforts to control the pandemic.

This service was performed 72 times for 71 patients

Administration of influenza virus vaccine

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.

This service was performed 59 times for 58 patients

Fee covid-19 vac 14 res

The "Fee covid-19 vac 14 res" refers to a charge for a specific service related to the COVID-19 vaccine. This could be for administering the vaccine or related care. It's crucial to get vaccinated to protect against the virus. The fee ensures quality service.

This service was performed 47 times for 47 patients

Influenza vaccine split virus, preservative free

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.

This service was performed 52 times for 52 patients

Medical Equipment Supplier

The provider carries the following medical supplies product categories:

PTAN
20304233
Accepts Medicare Assignment
YES
Specialities List
Pharmacy.
Competitive Bidding
NO

Supplies List

  • 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
  • Canes and/or Crutches - Standard Canes, Quad Canes, Offset Canes, Standard Crutches, Forearm Crutches
  • Walkers - Standard Walkers, Wheeled Walkers, Folding Walker
  • Ostomy Supplies - Pouches, Paste, Powder, Barrier wipes
  • Urological Supplies - Catheters, Urinary collection devices
  • Enteral Nutrients - Enteral formula
  • Enteral Equipment and/or Supplies - Enteral infusion pumps, enteral nutrition supply kits
  • Nebulizer Equipment and/or Supplies - Nebulizers, Atomizers, Filters
  • Surgical Dressings - Gauze, Elastic bandages, Adhesive tape

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
11D2121170
Facility Type
Other - RETAIL PHARMACY
Certificate Effective Date
November 01, 2024
Certificate Expiration Date
October 31, 2026
Laboratory Director
CHUCK PAGE
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to The Kroger Co to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1780134403, we treat the final digit (3) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 57. The final step is to find the difference between that total and the next multiple of ten (60 - 57 = 3).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
7
Unchanged
Pos 3
8
Doubled → 16 → 1 + 6
Pos 4
0
Unchanged
Pos 5
1
Doubled → 2
Pos 6
3
Unchanged
Pos 7
4
Doubled → 8
Pos 8
4
Unchanged
Pos 9
0
Doubled → 0
Check
3
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 8 → 16 → 7 1 → 2 4 → 8 0 → 0

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 7 + 1 + 6 + 0 + 2 + 3 + 8 + 4 + 0 + 24 = 57

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 57 is 60. The difference is the calculated check digit.

60 - 57 = 3
This NPI is valid
The calculated check digit is 3, which matches the last digit of 1780134403.

Other Providers at the Same Location


The following 1 provider is registered at the same or a nearby location.

Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
2452 MOROSGO WAY NE
ATLANTA, GA 30324

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1780134403, enumerated as an "organization" on October 05, 2016.

The provider is located at 2452 MOROSGO WAY NE ATLANTA, GA 30324 and the phone number is (404) 946-0450.

Pharmacy with taxonomy code 3336C0003X and a focus in Community/Retail Pharmacy.

The provider might be accepting Accepts: AvMed, Humana, Medica, Mending Health, Moda Health. Please consult your insurance carrier or call the provider to verify.