Organization
KROGER CO OF MICHIGAN
Active
Other names
Kroger Pharmacy #749
Organization subpart
No
Provider details
NPI number
Authorized official
BILL SHINTON (VICE PRESIDENT KROGER HEALTH)
(513) 762-1090
Entity
Organization
Contact information
Practice address
22801 HARPER AVE, ST. CLAIR SHORES, MI 48080
(586) 800-5190
(586) 800-5195
Mailing address
PO BOX 842772, BOSTON, MA 02284-2772
(513) 762-1019
(513) 762-1092
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301008647
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2042697
PK
—
05
—
2369975
—
MI
Enumeration date
07/19/2007
Last updated
06/14/2021
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us