Kroger

NPI #1043691009 in Knoxville, Tennessee

Provider Information

NPI Number: 1043691009
Entity Type: Organization
Organization Name: Kroger
Primary Specialty: Pharmacy
Enumeration Date: Jun 16, 2015
Last Updated: Jun 16, 2015

Practice Location

Address: 2217 N BROADWAY ST
City: Knoxville
State: Tennessee
ZIP Code: 37917-4719
Phone: (865) 525-4629

Authorized Official

Name: KARLA LANGWORTHY
Title: MANAGER OF PHARMACY CREDENTIALING
Phone: (513) 698-1878

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacy	333600000X	Primary

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