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Organization

THE KROGER CO

Active
Other names
KROGER PHARMACY #678
Organization subpart
No

Provider details

NPI number
Authorized official
JESSIE WARMAN (MANAGER OF PHARMACY LICENSING)
(513) 762-1263
Entity
Organization

Contact information

Practice address
1028 ROBERTS BRANCH PKWY, COLUMBIA, SC 29203
(803) 234-7150
(803) 234-2212
Mailing address
PO BOX 842772, BOSTON, MA 02284-2772
(513) 762-1019

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
333600000X
Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2160067
PK
Enumeration date
05/11/2016
Last updated
07/20/2018
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