Organization
KROGER LIMITED PARTNERSHIP I
Active
Other names
Kroger Pharmacy #011
Organization subpart
No
Provider details
NPI number
Authorized official
VICTORIA LYNN ANDREWS (MANAGER OF LICENSING)
(513) 762-1090
Entity
Organization
Contact information
Practice address
301 LOGISTICS AVE, JEFFERSONVILLE, IN 47130-4676
(812) 406-2377
Mailing address
PO BOX 842772, BOSTON, MA 02284-2772
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336M0002X
Mail Order Pharmacy
—
—
Other
Enumeration date
03/08/2022
Last updated
03/08/2022
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