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General NPI Number Information
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NPI Number | 1245264050
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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 | 07/10/2006
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Last Update Date | 02/26/2025
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Provider Practice Location Address
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Address Line | 7380 SPOUT SPRINGS RD
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City | FLOWERY BRANCH
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State | GA
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Zip | 30542-7541
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Country | US
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Telephone | 770-965-5644
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Fax | 770-965-5632
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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 | 19182-0242
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Country | US
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Telephone | 513-387-8725
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Fax | 513-762-1092
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Authorized Official
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Title or Position | MANAGER OF PHARMACY LICENSING
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Name | AMBER WILLIAMS
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Credential |
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Telephone | 513-387-8725
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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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 | 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 #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 8734
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License Number State | GA
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