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General NPI Number Information
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NPI Number | 1861426678
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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 | 07/10/2006
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Last Update Date | 04/21/2025
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Provider Practice Location Address
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Address Line | 880 W EADS PKWY
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City | LAWRENCEBURG
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State | IN
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Zip | 47025-1169
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Country | US
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Telephone | 812-532-7360
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Fax | 812-537-0225
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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 | JESSIE WARMAN
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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 | 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 | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 60005146B
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License Number State | IN
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