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Organization
KROGER LIMITED PARTNERSHIP I
Active
Organization
KROGER LIMITED PARTNERSHIP I
Active
Other names
KROGER PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JESSIE WARMAN (MANAGER RX LICENSING)
(513) 762-1090
Entity
Organization
Contact information
Practice address
6306 COUNTY ROAD 107, PROCTORVILLE, OH 45669
(740) 886-5579
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
021040600
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0013178039
—
WV
05
—
0620662
—
OH
01
—
2076677
PK
—
Enumeration date
07/10/2006
Last updated
07/29/2019
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