Organization
THE KROGER CO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALLISON BREDESTEGE (MANAGER OF PHARMACY LICENSING)
(513) 762-1019
Entity
Organization
Contact information
Practice address
505 DACULA RD, DACULA, GA 30019-2125
(678) 407-8739
(678) 407-8741
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
PHRE009719
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003107006A
—
GA
01
—
2128329
PK
—
Enumeration date
01/10/2011
Last updated
12/21/2017
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us