Organization
KROGER LIMITED PARTNERSHIP I
Active
Other names
KROGER PHARMACY #25-457
Organization subpart
No
Provider details
NPI number
Authorized official
JESSIE WARMAN (MANAGER OF PHARMACY LICENSING)
(513) 762-1090
Entity
Organization
Contact information
Practice address
1230 N HOUSTON LEVEE RD, CORDOVA, TN 38018-6653
(901) 751-0394
(901) 751-1067
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
3794
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2093262
PK
—
05
—
4435865
—
TN
Enumeration date
07/13/2006
Last updated
04/22/2025
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