Organization
KROGER LIMITED PARTNERSHIP I
Active
Other names
Kroger Pharmacy #465
Organization subpart
No
Provider details
NPI number
Authorized official
JESSIE WARMAN (MANAGER PHARMACY LICENSING)
(513) 762-1090
Entity
Organization
Contact information
Practice address
4613 MARBURG AVE, CINCINNATI, OH 45209-5005
(513) 782-5120
(513) 782-5121
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
—
—
3336C0003X
Community/Retail Pharmacy
Primary
RTPC.022525750-03
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0149204
—
OH
01
—
2152156
PK
—
Enumeration date
05/22/2015
Last updated
02/04/2020
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