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
5601 HIGH ST W, PORTSMOUTH, VA 23703-3758
(757) 686-8527
(757) 686-5260
Mailing address
3631 PETERS CREEK RD NW, ROANOKE, VA 24019-2809
(540) 563-3593
(540) 563-1436
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
0201003508
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008508470
—
VA
01
—
2105038
PK
—
Enumeration date
07/10/2006
Last updated
04/07/2014
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