Organization
THE KROGER CO
Active
Other names
Kroger Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA WARMAN (MANAGER OF RX LICENSING)
(513) 762-1263
Entity
Organization
Contact information
Practice address
6001 HWY 20, SUGAR HILL, GA 30518
(678) 546-4113
(678) 546-4119
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
PHRE009671
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003105021A
—
GA
01
—
2126003
PK
—
Enumeration date
07/30/2010
Last updated
06/25/2018
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