Organization
KROGER LIMITED PARTNERSHIP I
Active
Other names
KROGER PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JESSIE WARMAN (MANAGER PHARMACY LICENSING)
(513) 762-1090
Entity
Organization
Contact information
Practice address
10101 LANDING WAY, MIAMISBURG, OH 45342-1159
(937) 384-4220
(937) 384-4221
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
022265500
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0078566
—
OH
01
—
2137488
PK
—
Enumeration date
10/18/2012
Last updated
02/04/2020
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