Organization
KROGER LIMITED PARTNERSHIP I
Active
Other names
KROGER PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
KARLA LANGWORTHY (MANAGER OF PHARMACY CREDENTIALING)
(513) 698-1878
Entity
Organization
Contact information
Practice address
7 MARKET PLACE, WESTON, WV 26452
(304) 269-3824
(304) 269-3966
Mailing address
3631 PETERS CREEK RD NW, ROANOKE, VA 24019-2809
(540) 563-3593
(540) 563-1436
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
552246
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0013178040
—
WV
01
—
2111390
PK
—
Enumeration date
07/10/2006
Last updated
04/08/2014
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