KROGER PHARMACY
NPI 1790067809
Pharmacy - Community/Retail Pharmacy in Milledgeville, GA

Q: What is The Kroger Co's NPI number?

The NPI number for The Kroger Co is 1790067809. It was assigned to this organization in the NPPES registry on September 14, 2011. The provider is doing business as Kroger Pharmacy.

Q: What is The Kroger Co's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for The Kroger Co was last updated on March 24, 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.

Active since September 14, 2011CLIA 11D2099014 · Waiver

2809 N COLUMBIA ST, MILLEDGEVILLE, GA 31061(478) 414-2145(478) 414-1135 Get Directions Write a Review

NPPES record last updated: March 24, 2017. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Mar 24, 2017, May 16, 2016, Jan 22, 2016 (3 updates tracked since 2016).

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About Kroger Pharmacy NPPES

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

KROGER PHARMACY (NPI 1790067809) is a healthcare organization registered as a community/retail pharmacy in Milledgeville, Georgia and active in the NPI registry since September 2011. The organization holds a CLIA Waiver certificate valid through July 19, 2027 and lists Allison Muennich, Manager Of Pharmacy Licensing, as its authorized official.

NPPES Registry Identity

NPI1790067809

Entity TypeOrganization

Primary Taxonomy3336C0003X

Legal Business NameTHE KROGER CO

Location Address2809 N COLUMBIA STMilledgeville, GA 31061-8465

Mailing AddressPo Box 842772Boston, MA 02284-2772 · (513) 762-1019 · Fax (513) 762-1092

Phone(478) 414-2145

Fax(478) 414-1135

Organization SubpartNo

Authorized OfficialAllison MuennichManager Of Pharmacy Licensing · (513) 762-1019

Enumeration DateSeptember 14, 2011

Last NPPES UpdateMarch 24, 20173 updates tracked since enumeration

✔ NPI 1790067809 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 GA · PHRE009783

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

2809 N COLUMBIA ST, Milledgeville, GA 31061

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Other Names 1

Doing Business AsKroger Pharmacy

Other Identifiers 5

Medicare PINP00003265

Medicare NSC0302061054

Medicare PINFLU346

Medicaid003122654AGA

Other2131974Pk

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 11D2099014

Kroger Pharmacy #694 · Milledgeville, GA

Active · expires Jul 19, 2027

CLIA Number11D2099014

Laboratory TypePharmacy

Certificate Effective DateJuly 20, 2025

Certificate Expiration DateJuly 19, 2027

Laboratory DirectorChuck Page

Laboratory Phone(478) 414-2160

Laboratory LocationKroger Pharmacy #6942809 North Columbia Street, Milledgeville, GA 31061

CLIA data matches this NPI record on: Address 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.

319 services318 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.

311 services310 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.

23 services23 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.

21 services21 patients

Other Providers at the Same Location NPPES 6

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

CARLA ELIZABETH WOODALL

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