Organization
KROGER CO OF MICHIGAN
Active
Other names
Kroger Pharmacy #416
Organization subpart
No
Provider details
NPI number
Authorized official
LYSETTE SEILHAMER (MANAGER OF LICENSING)
(513) 762-1090
Entity
Organization
Contact information
Practice address
15100 SILVER PKWY, FENTON, MI 48430-3449
(810) 208-2210
(810) 208-2205
Mailing address
1014 VINE ST, CINCINNATI, OH 45202-1141
(513) 762-1090
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
10/30/2025
Last updated
01/21/2026
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