Organization
KROGER LIMITED PARTNERSHIP I
Active
Other names
KROGER APOTHECARY MIDATLANTIC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFF THOMPSON (PHARMACY MERCHANDISER)
(540) 563-3593
Entity
Organization
Contact information
Practice address
621-F TOWNSHIP PLAZA, ROANOKE, VA 24014
(540) 345-6480
(540) 345-6844
Mailing address
621 TOWNSIDE RD SW STE F, ROANOKE, VA 24014-2297
(540) 345-6480
(540) 345-6844
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
0201003731
VA
3336C0003X
Community/Retail Pharmacy
Primary
0201003731
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4836055
NCPDP
—
Enumeration date
12/12/2007
Last updated
03/07/2023
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