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
6417 COLUMBUS PIKE, LEWIS CENTER, OH 43035
(740) 888-1290
(740) 888-1292
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
021995150
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2122401
PK
—
05
—
3009149
—
OH
Enumeration date
10/20/2009
Last updated
02/06/2020
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