Organization
THE KROGER CO
Active
Other names
Kroger Drugstore #664
Organization subpart
No
Provider details
NPI number
Authorized official
LYSETTE SEILHAMER (MANAGER OF LICENSING)
(515) 762-1090
Entity
Organization
Contact information
Practice address
3942 HARPER FRANKLIN AVE., AUGUSTA, GA 30309
(706) 261-5210
(706) 261-5212
Mailing address
PO BOX 842772, BOSTON, MA 02284-2772
(513) 762-1090
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
03/15/2024
Last updated
03/15/2024
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