Organization
KROGER LIMITED PARTNERSHIP I
Active
Other names
KROGER PHARMACY 946
Organization subpart
No
Provider details
NPI number
Authorized official
JESSIE WARMAN (MANAGER RX LICENSING)
(513) 762-1090
Entity
Organization
Contact information
Practice address
1818 AIRPORT PLAZA, DECATUR, IL 62521-9717
(217) 864-5912
(217) 864-4861
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
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
054013355
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2023567
PK
—
Enumeration date
11/15/2006
Last updated
03/31/2020
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