Organization
KROGER PHARMACY
Active
Parent organization
KROGER COMPANY
Organization subpart
Yes
Provider details
NPI number
Legal business name
KROGER COMPANY
Authorized official
RHONNY VALENTINE (PHARMACIST IN CHARGE)
(318) 795-9966
Entity
Organization
Contact information
Practice address
6652 YOUREE DR, SHREVEPORT, LA 71105-4630
(318) 795-9966
Mailing address
1105 ISLAND PARK BLVD, 714, SHREVEPORT, LA 71105-4741
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
021693
LA
Other
Enumeration date
10/11/2016
Last updated
10/11/2016
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