KROGER PHARMACY – Community/Retail Pharmacy, NPI 1770517484

KROGER PHARMACY is a healthcare provider. based in Boston, Massachusetts. specializing in Community/Retail Pharmacy. The organization holds a License No. 020125110 (OH). The NPI Number for KROGER PHARMACY is 1770517484

Main info

Organization
Name
KROGER PHARMACY
NPI
1770517484
Phone
(513) 762-1019
Address
PO BOX 842772
Authorized Official
JESSIE WARMAN MANAGER PHARMACY LICENSING
Enumeration Date
10 July 2006
Last Update Date
5 February 2020
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience72
Completeness80
Years active:19State licenses:1Digital endpointsUpdated within 12 months

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Provider Addresses for KROGER PHARMACY

  • PO Box 846028, Albany Street, Church Green, Financial District, Boston, Suffolk County, Massachusetts, 02284-6028, United States

    BOSTON, MA 022842772

    Phone: (513) 762-1019

    Fax: (513) 762-1092

    Type: Mailing

  • Kroger, 1996, Tiffin Avenue, Lantern Gate Condo 1, Findlay, Hancock County, Ohio, 45840, United States

    FINDLAY, OH 458406741

    Phone: (419) 427-3662

    Fax: (419) 427-3664

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2010-09-30

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2024-10-31 (585 days ago).

Enrollment records

1

Earliest due date

2024-10-31

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20100930038793OPharmacyOH2024-10-31

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
G0008Administration of influenza virus vaccine366364$0
90662Influenza vaccine split virus, preservative free346345$0
90480Admn sarscov2 vacc 1 dose250250$0
91322Sarscov2 vac 50 mcg/0.5ml im183183$0
K1034Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count13022$0
View full utilization report →

Insurance plans in this area (ZIP 02284)

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Reviews

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Frequently asked questions

What is the standard ID for KROGER PHARMACY in the U.S.?
In the U.S., KROGER PHARMACY is identified by NPI 1770517484.
Is KROGER PHARMACY's NPI status active today?
Active status means KROGER PHARMACY's NPI record is not deactivated in the public file.
How should patients interpret KROGER PHARMACY's specialty?
The extract shows Community/Retail Pharmacy for KROGER PHARMACY. Clinical services aligned with this taxonomy classification.
Is KROGER PHARMACY tied to Boston, Massachusetts?
If you are local to Boston, Massachusetts, KROGER PHARMACY may be relevant to your search.
Why is information missing for KROGER PHARMACY?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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