Organization
THE KROGER CO
Active
Other names
KROGER DRUGSTORE #477
Organization subpart
No
Provider details
NPI number
Authorized official
JESSIE WARMAN (MANAGER RX LICENSING)
(513) 762-1090
Entity
Organization
Contact information
Practice address
2121 LAWRENCEVILLE SUWANEE RD, SUWANEE, GA 30024-2657
(770) 962-1352
(770) 962-3709
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
8425
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00869503A
—
GA
01
—
2020430
PK
—
Enumeration date
07/10/2006
Last updated
08/27/2019
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us