Organization
KROGER LIMITED PARTNERSHIP I
Active
Other names
KROGER PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MATT MINEER (INTERFACE MANAGER)
(513) 387-7074
Entity
Organization
Contact information
Practice address
350 E SIX FORKS RD, RALEIGH, NC 27609-7879
(919) 835-9593
(919) 835-9837
Mailing address
150 TRI COUNTY PKWY, CINCINNATI, OH 45246-3217
(513) 782-3384
(513) 782-8760
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336I0012X
Institutional Pharmacy
Primary
7489
NC
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0920118
—
NC
01
—
3437337
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
07/13/2006
Last updated
06/24/2009
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