Organization
KROGER LIMITED PARTNERSHIP I
Active
Other names
KROGER PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
KARLA LANGWORTHY (PHARMACY LICENSING MANAGER)
(513) 698-1878
Entity
Organization
Contact information
Practice address
3032 E CUMBERLAND RD, BLUEFIELD, WV 24701-4858
(304) 327-0823
(304) 327-0828
Mailing address
3631 PETERS CREEK RD NW, ROANOKE, VA 24019-2809
(540) 563-3593
(540) 563-1436
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
552243
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0013178037
—
WV
05
—
008517592
—
VA
01
—
5011440
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
07/10/2006
Last updated
04/23/2012
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