Organization
THE KROGER CO
Active
Other names
Kroger Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JESSIE WARMAN (MANAGER OF PHARMACY LICENSING)
(513) 762-1019
Entity
Organization
Contact information
Practice address
131 STATE ROUTE 3, SUNBURY, OH 43074
(740) 965-0520
(740) 965-0522
Mailing address
PO BOX 842772, BOSTON, MA 02284-2772
(513) 762-1019
(513) 762-1092
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
021912950
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2117748
PK
—
05
—
2877909
—
OH
Enumeration date
10/31/2008
Last updated
02/06/2020
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