National Provider Identifier Database

KROGER CO OF MICHIGAN
Community/Retail Pharmacy

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.


Contact Information

KROGER CO OF MICHIGAN
22801 HARPER AVE
SAINT CLAIR SHORES, MI48080
Phone: 586-800-5190
Fax: 586-800-5195
Website:
Specialty Taxonomy Code
* Community/Retail Pharmacy 3336C0003X
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X

* Indicates primary specialty

NPI Profile & details for KROGER CO OF MICHIGAN

NPI Number 1154521060
Legal business name
LBN
KROGER CO OF MICHIGAN
Authorized official BILL SHINTON - (VICE PRESIDENT KROGER HEALTH)
Entity Organization
Organization subpart No
Enumeration date 07/19/2007
Last updated 06/14/2021 - About 5 years ago
Sole proprietor1 Not specified
Identifiers
  • MI License #: 5301008647
  • MI Medicaid: 2369975
  • Other: 2042697 PK

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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