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Organization
THE KROGER CO
Active
Organization
THE KROGER CO
Active
Other names
KROGER PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JESSIE WARMAN (MANAGER OF PHARMACY LICENSING)
(513) 762-1019
Entity
Organization
Contact information
Practice address
7467 SAINT ANDREWS RD, STE 6, IRMO, SC 29063
(803) 732-0426
(803) 732-2698
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
—
NULL
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
1750
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2089121
PK
—
05
—
717505
—
SC
Enumeration date
07/10/2006
Last updated
07/20/2018
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