KROGER PHARMACY - NPI 1972801025 - Pharmacy in Roanoke, VA

Q: What is the provider's specialty?

The provider's specialty is Pharmacy with taxonomy code 3336C0003X and a focus in Community/Retail Pharmacy.

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About Kroger Pharmacy NPPES

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

KROGER PHARMACY (NPI 1972801025) is a healthcare organization registered as a community/retail pharmacy in Roanoke, Virginia and active in the NPI registry since March 2011. The organization holds a CLIA Waiver certificate valid through December 29, 2026 and lists Karla Langworthy, Pharmacy Licensing Manager, as its authorized official.

NPPES Registry Identity

NPI1972801025

Entity TypeOrganization

Primary Taxonomy3336C0003X

Legal Business NameKROGER LIMITED PARTNERSHIP I

Location Address3631 PETERS CREEK RD NWRoanoke, VA 24019-2809

Mailing Address1014 Vine St, 3rd FloorCincinnati, OH 45202-1141 · (513) 698-1878 · Fax (513) 762-1092

Phone(540) 563-3593

Fax(513) 563-1463

Organization SubpartNo

Authorized OfficialKarla LangworthyPharmacy Licensing Manager · (513) 698-1878

Enumeration DateMarch 14, 2011

✔ NPI 1972801025 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers

Taxonomy Code3336C0003X

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

3631 PETERS CREEK RD NW, Roanoke, VA 24019

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Other Names 1

Doing Business AsKroger Pharmacy

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 49D1093735

Kroger Pharmacy #202 · Roanoke, VA

Active · expires Dec 29, 2026

CLIA Number49D1093735

Laboratory TypePharmacy

Certificate Effective DateDecember 30, 2024

Certificate Expiration DateDecember 29, 2026

Laboratory DirectorJamie Remines

Laboratory Phone(540) 563-3321

Laboratory LocationKroger Pharmacy #2024488 Electric Road, Roanoke, VA 24014

CLIA data matches this NPI record on: Name

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 8

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

DOROTHY S SHAVER RD,LD/N

Dietitian, Registered