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General NPI Number Information
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NPI Number | 1861511834
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Entity Type | Organization
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Legal Business Name | KROGER HEALTH SOLUTIONS
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Dates
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Enumeration Date | 03/28/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 350 E SIX FORKS RD
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City | RALEIGH
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State | NC
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Zip | 27609
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Country | US
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Telephone | 919-835-9596
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Fax | 919-835-9837
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Provider Business Mailing Address
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Address Line | 350 SIX FORKS RD
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City | RALEIGH
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State | NC
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Zip | 27609
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Country | US
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Telephone | 919-835-9596
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Fax | 919-835-9837
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Authorized Official
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Title or Position | PHARMACIST
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Name | CHET KANJIA
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Credential | PHT
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Telephone | 919-835-9596
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 07489
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License Number State | NC
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