Organization
KROGER LIMITED PARTNERSHIP I
Active
Other names
KROGER PHARMACY #395
Organization subpart
No
Provider details
NPI number
Authorized official
JESSIE WARMAN (MANAGER PHARMACY LICENSING)
(513) 762-1090
Entity
Organization
Contact information
Practice address
1001 CHERRY ST, STE A, BLANCHESTER, OH 45107-1346
(937) 783-0270
(937) 783-0295
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
021637900
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2080614
PK
—
05
—
2731511
—
OH
Enumeration date
12/27/2006
Last updated
02/03/2020
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