Organization
KROGER LIMITED PARTNERSHIP I
Active
Other names
SCOTTS PHARMACY J403
Organization subpart
No
Provider details
NPI number
Authorized official
KARLA LANGWORTHY CPHT (PHARMACY LICENSING MANAGER)
(513) 698-1878
Entity
Organization
Contact information
Practice address
710 E DUPONT RD, FORT WAYNE, IN 46825-2056
(260) 489-2878
(260) 490-2421
Mailing address
5960 CASTLEWAY WEST DR, INDIANAPOLIS, IN 46250-1977
(317) 579-8434
(317) 579-8424
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
60006079A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1561566
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
06/13/2007
Last updated
07/26/2010
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