- Practice location
- 16705 Fort St, Southgate, MI 48195-1442
- Phone
- 734-324-7966
- Fax
- 734-324-7970
- Last updated
- January 25, 2019
Kroger Co Of Michigan is a healthcare organization based in Southgate, MI. Kroger Co Of Michigan practices in Southgate, MI. The NPI Number for Kroger Co Of Michigan is 1356375109 and holds a License No. 5301007373 (MI). The current practice location address for Kroger Co Of Michigan is 16705 Fort St, Southgate, MI 48195-1442 and can be reached out via phone at 734-324-7966 and via fax at 734-324-7970.
Provider Profile Details
- NPI Number
- 1356375109
- Provider Name
- Kroger Co Of Michigan
- Provider Entity Type
- Organization
- Address
- 16705 Fort St, Southgate, MI 48195-1442
- Phone Number
- 734-324-7966
- Fax Number
- 734-324-7970
- Primary Taxonomy
- Pharmacy, Community/Retail Pharmacy · 3336C0003X
- Organization Subpart
- No
- Authorized Official
- Jessie Warman · Manager Rx Licensing · 513-762-1090
- Other Names
- Kroger Pharmacy (Doing Business As)
- Provider Enumeration Date
- July 10, 2006
- Last Update Date
- January 25, 2019
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 16705 Fort St
Southgate, MI 48195-1442 - City
- Southgate
- State
- Michigan
- Zip
- 48195-1442
- Phone Number
- 734-324-7966
- Fax Number
- 734-324-7970
Provider Business Mailing Address Details
- Address
- Po Box 842772
Boston, MA 02284-2772 - City
- Boston
- State
- MA
- Zip
- 02284-2772
- Phone Number
- 513-762-1019
- Fax Number
- 513-762-1092
License Information
- Taxonomy (1)
- Durable Medical Equipment & Medical Supplies · 332B00000X
- Taxonomy (2)
- Pharmacy · 333600000X
- License Number (3)
- 5301007373
- License State (3)
- MI
- Taxonomy (3)
- Pharmacy, Community/Retail Pharmacy · 3336C0003X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
Other Pharmacy, Community/Retail Pharmacy providers near Southgate, MI
View all Pharmacy, Community/Retail Pharmacy providers in Southgate →Frequently Asked Questions
What is the NPI number of Kroger Co Of Michigan?
The NPI number of Kroger Co Of Michigan is 1356375109. It was assigned on July 10, 2006 and is currently active in the NPPES registry.
What is the specialty of Kroger Co Of Michigan?
Kroger Co Of Michigan is registered under the primary taxonomy Pharmacy, Community/Retail Pharmacy (code 3336C0003X), licensed in MI under license number 5301007373.
Where does Kroger Co Of Michigan practice?
The practice location is 16705 Fort St, Southgate, MI 48195-1442. The office can be reached at 734-324-7966 (phone) or 734-324-7970 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1356375109 directly on the NPPES registry website.