| NPI | 1154142909 |
|---|---|
| Doing Business As | KROGER PHARMACY #639 |
| Entity Type | Organization |
| Authorized Contact | AMBER NICOLE WILLIAMS Licensing Manager 513-762-1090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2024-10-23 |
| Last Update Date | 2024-10-23 |