Organization
KROGER LIMITED PARTNERSHIP I
Active
Other names
Kroger Pharmacy #971, KROGER PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
LYSETTE SEILHAMER (MANAGER OF LICENSING)
(513) 762-1090
Entity
Organization
Contact information
Practice address
3073 DIXIE HWY, EDGEWOOD, KY 41018-1829
(859) 344-0434
(859) 344-1658
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
—
—
3336C0003X
Community/Retail Pharmacy
Primary
P02119
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2031439
PK
—
05
—
54023668
—
KY
Enumeration date
07/10/2006
Last updated
10/16/2025
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