KROGER PHARMACY
NPI 1144254905
Pharmacy - Community/Retail Pharmacy in West Bloomfield, MI
NPI Status: Active since July 10, 2006
Contact Information
4805 HAGGERTY RD
WEST BLOOMFIELD, MI
ZIP 48323
Phone: (248) 960-7535
Fax: (248) 960-7529
- Organization
- Pharmacy
- Community/Retail Pharmacy
- CLIA Number: 23D2077115
- CLIA Cert. Type: Other - RETAIL PHARMACY
- CLIA Exp. Date: 04-30-2026
About KROGER PHARMACY
This page provides the complete NPI Profile along with additional information for Kroger Pharmacy, a provider established in West Bloomfield, Michigan operating as a Pharmacy, focusing in community/retail pharmacy . The healthcare provider is registered in the NPI registry with number 1144254905 assigned on July 2006. The practitioner's primary taxonomy code is 3336C0003X with license number 5301006519 (MI). The provider is registered as an organization and their NPI record was last updated 7 years ago. The provider's is doing business as Kroger Pharmacy. The authorized official of this NPI record is Jessie Warman (Manager Rx Licensing)
- NPI
- 1144254905
- Provider Legal Name
- KROGER CO OF MICHIGAN
- Other Organization Name
- KROGER PHARMACY
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 4805 HAGGERTY RD WEST BLOOMFIELD, MI 48323
- Location Phone
- (248) 960-7535
- Location Fax
- (248) 960-7529
- Mailing Address
- 40399 GRAND RIVER AVE STE 110 NOVI, MI 48375
- Mailing Phone
- (248) 536-1545
- Mailing Fax
- (248) 960-7529
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 07-10-2006
- Last Update Date
- 01-25-2019
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Pharmacy Community/Retail Pharmacy
- Taxonomy Code
- 3336C0003X
- Type
- Suppliers
- License No.
- 5301006519
- License State
- MI
- Taxonomy Description
- 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.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 332B00000X | Suppliers | Durable Medical Equipment & Medical Supplies | |
| 2 | 333600000X | Suppliers | Pharmacy |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 3314768 | MEDICAID (05) | MI | |
| 2043467 | OTHER (01) | PK |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 23D2077115
- Facility Type
- Other - RETAIL PHARMACY
- Certificate Effective Date
- May 01, 2024
- Certificate Expiration Date
- April 30, 2026
- Laboratory Director
- ROBERT BROWN
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Kroger Pharmacy to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 1 | 4 | 4 | 2 | 5 | 4 | 9 | 0 | 5 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 1 | 8 | 4 | 4 | 5 | 8 | 9 | 0 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 1 + 8 + 4 + 4 + 5 + 8 + 9 + 0 + 24 = 65 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 65 = 5 | 5 | ||||||||
The NPI number 1144254905 is valid because the calculated check digit 5 using the Luhn validation algorithm matches the last digit of the original NPI number.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1144254905, enumerated in the NPI registry as an "organization" on July 10, 2006
The provider is located at 4805 Haggerty Rd West Bloomfield, Mi 48323 and the phone number is (248) 960-7535
This medical organization specializes in Pharmacy with taxonomy code 3336C0003X with a focus in Community/Retail Pharmacy
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
The provider's CLIA number is 23D2077115 for a "other - retail pharmacy" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..
This NPI record was last updated on July 10, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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