THE KROGER CO
NPI 1982908687
Pharmacy - Community/Retail Pharmacy in Dacula, GA

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

The NPI number for The Kroger Co is 1982908687. It was assigned to this organization in the NPPES registry on January 10, 2011.

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 December 21, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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 January 10, 2011

505 DACULA RD, DACULA, GA 30019(678) 407-8739(678) 407-8741 Get Directions Write a Review

NPPES record last updated: December 21, 2017. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 21, 2017, Mar 23, 2017, Jun 27, 2016 and 2 more (5 updates tracked since 2016).

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About The Kroger Co NPPES

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

THE KROGER CO (NPI 1982908687) is a healthcare organization registered as a community/retail pharmacy in Dacula, Georgia and active in the NPI registry since January 2011. The organization lists Allison Bredestege, Manager Of Pharmacy Licensing, as its authorized official.

NPPES Registry Identity

NPI1982908687

Entity TypeOrganization

Primary Taxonomy3336C0003X

Legal Business NameTHE KROGER CO

Location Address505 DACULA RDDacula, GA 30019-2125

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

Phone(678) 407-8739

Fax(678) 407-8741

Organization SubpartNo

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

Enumeration DateJanuary 10, 2011

Last NPPES UpdateDecember 21, 20175 updates tracked since enumeration

✔ NPI 1982908687 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 · PHRE009719

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

505 DACULA RD, Dacula, GA 30019

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Other Identifiers 2

Medicaid003107006AGA

Other2128329Pk

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 ›

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.

58 services57 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.

55 services54 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.

13 services13 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.

12 services12 patients

Medical Equipment Supplier Medicare DMEPOS 14

Medicare supplier enrollment and the product categories Kroger Pharmacy #635 carries, from the Medicare DMEPOS supplier directory.

Kroger Pharmacy #635

DMEPOS supplier · Dacula, GAOperated by The Kroger Co

✔

Accepts Medicare assignment

Kroger Pharmacy #635 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)20304425

Medicare Participant SinceOctober 18, 2023

Supplier Location505 Dacula RdDacula, GA 30019

Phone(678) 407-8740

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 13

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

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Nurse Practitioner (Family)