MEDICARE: THE KROGER CO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	333600000X	Pharmacy
3	3336C0003X	Community/Retail Pharmacy	020059356	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2075938	OTHER		PK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1740214543
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE KROGER CO

Provider Business Mailing Address
First Line	:	PO BOX 842772
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02284-2772
Country	:	US
Telephone Number	:	513-762-1019
Fax Number	:	513-762-1092

Provider Business Practice Location Address
First Line	:	6235 MONROE ST
Second Line	:
City	:	SYLVANIA
State	:	OH
Zip	:	43560-1427
Country	:	US
Telephone Number	:	419-885-4738
Fax Number	:	419-885-4879

Authorized Official
Title or Position	:	MANAGER PHARMACY LICENSING
Name	:	JESSIE WARMAN
Credential	:
Telephone Number	:	513-762-1090

Provider Enumeration Date	:	07/10/2006
Last Update Date	:	02/06/2020

Similar Medicare Providers

1427563766 — SAMIR SALMAN
Practice Location Address:

6235 MONROE ST
SYLVANIA, OH
43560-1427

Practice Phone: 419-885-4738
Practice Fax:

1013799543 — DR. MARY ANTYPAS PHARMD
Practice Location Address:

6235 MONROE ST
SYLVANIA, OH
43560-1427

Practice Phone: 419-885-4738
Practice Fax: 419-824-9701

1760199053 — MADISON IMBODEN
Practice Location Address:

6235 MONROE ST
SYLVANIA, OH
43560-1427

Practice Phone: 419-885-4738
Practice Fax:

1154831204 — LISA JEAN COMTE RPH
Practice Location Address:

6235 MONROE ST
SYLVANIA, OH
43560-1427

Practice Phone: 419-885-4738
Practice Fax:

1093641714 — LEVELING UP LLC
Practice Location Address:

5600 MONROE ST STE B207
SYLVANIA, OH
43560-2728

Practice Phone: 419-327-7475
Practice Fax:

1811547805 — MRS. DANA MCKINNEY CNP
Practice Location Address:

5700 MONROE ST UNIT 210
SYLVANIA, OH
43560-2737

Practice Phone: 567-585-0490
Practice Fax: 567-585-0491

Directions to “THE KROGER CO ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.