Organization
KROGER LIMITED PARTNERSHIP I
Active
Other names
KROGER PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
VICTORIA LYNN ANDREWS (MANAGER OF LICENSING)
(513) 762-1090
Entity
Organization
Contact information
Practice address
975 N GREEN ST, BROWNSBURG, IN 46112-1032
(317) 852-3340
(317) 852-1200
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
60005139
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100297070A
—
IN
01
—
2026283
PK
—
Enumeration date
11/15/2006
Last updated
01/03/2022
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