Organization
KROGER LIMITED PARTNERSHIP I
Active
Organization
KROGER LIMITED PARTNERSHIP I
Active
Other names
KROGER PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
VICTORIA LYNN ANDREWS (MANAGER OF LICENSING)
(937) 728-8628
Entity
Organization
Contact information
Practice address
300 W SERVICE RD, WEST MEMPHIS, AR 72301-1726
(870) 732-0283
(870) 732-4871
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
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
420091
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
140048407
—
AR
01
—
1988129
PK
—
Enumeration date
07/10/2006
Last updated
02/22/2022
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