Organization
KROGER CO
Active
Other names
Kroger Drugstore #622
Organization subpart
No
Provider details
NPI number
Authorized official
LYSETTE SEILHAMER (MANAGER OF LICENSING)
(513) 762-1090
Entity
Organization
Contact information
Practice address
995 LOGANVILLE HIGHWAY, BETHLEHEM, GA 30620
(470) 900-2960
(470) 900-2961
Mailing address
PO BOX 830242, PHILADELPHIA, PA 19183-0352
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
09/25/2025
Last updated
09/25/2025
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