KROGER PHARMACY – Community/Retail Pharmacy, NPI 1124052865
Community/Retail Pharmacy
Main info
Profile Insights
NPPES metrics only — not quality of care.
Loading map...
Provider Addresses for KROGER PHARMACY
Kroger, 4038, Old Denton Road, Carrollton, Denton County, Texas, 75007, United States
CARROLLTON, TX 75007
Phone: (972) 512-3366
Fax: (972) 512-3367
Type: Location
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
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
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 2024-06-30 (709 days ago).
Enrollment records
1
Earliest due date
2024-06-30
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20100930022382 | O | Pharmacy | TX | 2024-06-30 |
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.
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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| G0008 | Administration of influenza virus vaccine | 282 | 281 | $0 |
| 90662 | Influenza vaccine split virus, preservative free | 274 | 274 | $0 |
| K1034 | Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count | 231 | 25 | $0 |
| 90480 | Admn sarscov2 vacc 1 dose | 206 | 206 | $0 |
| 91320 | Sarscv2 vac 30mcg trs-suc im | 156 | 156 | $0 |
Insurance plans in this area (ZIP 75007)
Loading plans...
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.