Organization
KROGER LIMITED PARTNERSHIP I
Active
Other names
KROGER PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
KARLA LANGWORTHY (MANAGER OF PHARMACY CREDENTIALING)
(513) 698-1878
Entity
Organization
Contact information
Practice address
3830 HICKORY HILL RD, MEMPHIS, TN 38115-5024
(901) 353-8274
(901) 353-8279
Mailing address
800 RIDGE LAKE BLVD, MEMPHIS, TN 38120-9427
(901) 765-4157
(901) 765-4213
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
C3355
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2092519
PK
—
05
—
4432403
—
TN
Enumeration date
07/13/2006
Last updated
04/07/2014
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