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General NPI Number Information
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NPI Number | 1083599377
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Entity Type | Organization
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Legal Business Name | KROGER LIMITED PARTNERSHIP I
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Dates
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Enumeration Date | 08/07/2025
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Last Update Date | 08/07/2025
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Provider Practice Location Address
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Address Line | 6745 BEULAH CHURCH RD
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City | LOUISVILLE
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State | KY
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Zip | 40228-2415
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Country | US
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Telephone | 502-357-0895
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Fax | 502-812-1931
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Provider Business Mailing Address
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Address Line | PO BOX 830242
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City | PHILADELPHIA
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State | PA
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Zip | 19183-0352
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Country | US
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Telephone | 513-762-1090
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Fax |
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Authorized Official
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Title or Position | MANAGER OF LICENSING
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Name | LYSETTE SEILHAMER
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Credential |
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Telephone | 513-762-1090
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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