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Organization

KROGER LIMITED PARTNERSHIP I

Active
Other names
KROGER PHARMACY
Organization subpart
No

Provider details

NPI number
Authorized official
CHELSIE CRAFT (PHARMACY LICENSING ASP)
(513) 762-1019
Entity
Organization

Contact information

Practice address
507 FOOTHILLS PLZ, MARYVILLE, TN 37801-2312
(865) 681-4924
(865) 681-5180
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
3742
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2093226
PK
Enumeration date
07/10/2006
Last updated
04/06/2023
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