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General NPI Number Information
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NPI Number | 1154142909
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Entity Type | Organization
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Legal Business Name | THE KROGER CO
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Dates
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Enumeration Date | 10/23/2024
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Last Update Date | 10/23/2024
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Provider Practice Location Address
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Address Line | 1006 MARTINS CHAPEL RD
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City | LAWRENCEVILLE
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State | GA
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Zip | 30045-6644
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Country | US
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Telephone | 770-496-5332
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 830424
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City | PHILADELPHIA
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State | PA
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Zip | 19182-0530
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Country | US
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Telephone | 770-496-5332
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Fax |
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Authorized Official
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Title or Position | LICENSING MANAGER
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Name | AMBER NICOLE WILLIAMS
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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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