Organization
KROGER LIMITED PARTNERSHIP I
Active
Organization
KROGER LIMITED PARTNERSHIP I
Active
Other names
Kroger Pharmacy #698
Organization subpart
No
Provider details
NPI number
Authorized official
LYSETTE SEILHAMER (PHARMACY LICENSING MANAGER)
(515) 762-1090
Entity
Organization
Contact information
Practice address
5201 N BROADWAY ST, KNOXVILLE, TN 37918-2345
(865) 686-1020
(865) 656-1021
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
0000004680
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1519814
—
TN
01
—
2122366
PK
—
Enumeration date
10/19/2009
Last updated
04/06/2023
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