Organization
KROGER CO OF MICHIGAN
Active
Organization
KROGER CO OF MICHIGAN
Active
Other names
KROGER PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JESSIE WARMAN (MANAGER RX LICENSING)
(513) 762-1090
Entity
Organization
Contact information
Practice address
3200 CARPENTER RD, YPSILANTI, MI 48197-9630
(734) 971-7283
(734) 971-7015
Mailing address
PO BOX 842772, BOSTON, MA 02284-2772
(513) 762-1090
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301006242
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2042715
PK
—
05
—
3122240
—
MI
Enumeration date
07/10/2006
Last updated
01/16/2019
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