Organization
THE KROGER CO
Active
Other names
Kroger Columbus Central Fill #019
Organization subpart
No
Provider details
NPI number
Authorized official
JESSIE WARMAN (MANAGER OF PHARMACY LICENSING)
(513) 762-1019
Entity
Organization
Contact information
Practice address
2270 RICKENBACKER PKWY W, COLUMBUS, OH 43217
(614) 333-5017
(614) 333-5029
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
022348200
OH
333600000X
Pharmacy
OH1762
KY
3336C0003X
Community/Retail Pharmacy
Primary
64000757A
IN
3336C0003X
Community/Retail Pharmacy
MO0560650
WV
3336M0002X
Mail Order Pharmacy
5315062714
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2141911
PK
—
Enumeration date
09/03/2013
Last updated
07/20/2018
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