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Organization
THE KROGER CO
Active
Organization
THE KROGER CO
Active
Other names
Kroger Pharmacy #784
Organization subpart
No
Provider details
NPI number
Authorized official
LYSETTE SEILHAMER (FACILITY LICENSING MANAGER)
(513) 587-5328
Entity
Organization
Contact information
Practice address
4085 MUNDY MILL RD., OAKWOOD, GA 30566
(678) 343-9690
(678) 971-0304
Mailing address
PO BOX 830242, PHILADELPHIA, PA 19182-0352
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
—
NULL
Other
Enumeration date
06/22/2026
Last updated
06/22/2026
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