Organization
KROGER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH BUMGARDNER SNOTHERLY (PHARMD)
(919) 624-6553
Entity
Organization
Contact information
Practice address
350 E SIX FORKS RD, RALEIGH, NC 27609-7879
(919) 838-2794
Mailing address
350 E SIX FORKS RD, RALEIGH, NC 27609-7879
(919) 838-2794
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
22678
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0326495
—
NC
Enumeration date
06/20/2014
Last updated
06/20/2014
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