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Organization

THE KROGER CO

Active
Other names
KROGER PHARMACY
Organization subpart
No

Provider details

NPI number
Authorized official
JESSIE WARMAN (MANAGER PHARMACY LICENSING)
(513) 762-1090
Entity
Organization

Contact information

Practice address
833 W ALEXIS RD, TOLEDO, OH 43612-4303
(419) 269-6909
(419) 269-6911
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
21304850
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2078588
PK
05
2299490
OH
Enumeration date
07/10/2006
Last updated
02/06/2020
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