Organization
KROGER LIMITED PARTNERSHIP I
Active
Other names
Kroger Pharmacy #419
Organization subpart
No
Provider details
NPI number
Authorized official
JESSIE WARMAN (MANAGER OF PHARMACY LICENSING)
(513) 762-1090
Entity
Organization
Contact information
Practice address
7735 FARMINGTON BLVD, MEMPHIS, TN 38138-2901
(901) 754-5124
(901) 758-3632
Mailing address
P.O. BOX 842772, BOSTON, MA 02284
(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
00004096
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2131580
PK
—
Enumeration date
08/29/2011
Last updated
04/22/2025
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