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NPI 1295750909

NPI 1295750909 : KROGER LIMITED PARTNERSHIP I : LIBERTY TWP, OH

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General NPI Number Information
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    NPI Number           |    1295750909
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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     |    07/13/2006
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    Last Update Date     |    04/21/2025
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Provider Practice Location Address
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    Address Line         |    5250 NEWTOWN DR 
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    City                 |    LIBERTY TWP
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    State                |    OH
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    Zip                  |    45011-1223
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    Country              |    US
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    Telephone            |    513-887-8464
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    Fax                  |    513-867-5421
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Provider Business Mailing Address
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    Address Line         |    PO BOX 842772 
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    City                 |    BOSTON
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    State                |    MA
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    Zip                  |    02284-2772
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    Country              |    US
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    Telephone            |    513-762-1019
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    Fax                  |    513-762-1092
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Authorized Official
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    Title or Position    |    MANAGER PHARMACY LICENSING
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    Name                 |     AMBER  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        |    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 #3
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    Taxonomy Code        |    3336C0003X
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    Taxonomy Name        |    Community/Retail Pharmacy
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    License Number       |    021055250
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    License Number State |    OH
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