# THE KROGER CO

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1982777405
- **Authorized official:** ALLISON BREDESTEGE (MANAGER OF PHARMACY LICENSING)
- **Authorized official phone:** (513) 762-1019

## Contact information

- **Practice address:** 6652 YOUREE DR, SHREVEPORT, LA 71105-4630
- **Practice address phone:** (318) 795-9966
- **Practice address fax:** (318) 795-0510
- **Mailing address:** PO BOX 842772, BOSTON, MA 02284-2772
- **Mailing address phone:** (513) 762-1019

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 3973RC | LA | Yes |

## Other

- **Enumeration date:** 11/15/2006
- **Last updated:** 03/15/2018