The Kroger Co

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

64000757A Issued in IN

Legal business name

THE KROGER CO

Practice address

2270 Rickenbacker Pkwy W
Columbus, OH 43217

Phone

(614) 333-5017

Fax

(614) 333-5029

NPI assigned

Sep 3, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jessie Warman

Title

Manager of Pharmacy Licensing

Phone

(513) 762-1019

Specialties & licenses 5

Addresses

Other identifiers 1

Other names 1

• Kroger Columbus Central Fill #019 Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1378166400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1532044800000",
    "number": "1649604166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 842772",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022842772",
            "telephone_number": "513-762-1019",
            "fax_number": "513-762-1092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2270 RICKENBACKER PKWY W",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "43217",
            "telephone_number": "614-333-5017",
            "fax_number": "614-333-5029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE KROGER CO",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-03",
        "last_updated": "2018-07-20",
        "status": "A",
        "authorized_official_last_name": "WARMAN",
        "authorized_official_first_name": "JESSIE",
        "authorized_official_title_or_position": "MANAGER OF PHARMACY LICENSING",
        "authorized_official_telephone_number": "513-762-1019"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "OH",
            "license": "022348200",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "KY",
            "license": "OH1762",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IN",
            "license": "64000757A",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WV",
            "license": "MO0560650",
            "primary": false
        },
        {
            "code": "3336M0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Mail Order Pharmacy",
            "state": "MI",
            "license": "5315062714",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2141911",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kroger Columbus Central Fill #019",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Kroger Columbus Central Fill #019",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• The Kroger Co
• The Kroger Co
• The Kroger Co
• The Kroger Co
• The Kroger Co
• The Kroger Co
• The Kroger Co
• The Kroger Co
• The Kroger Co
• The Lasik Vision Institute LLC

• Community/Retail Pharmacy in Columbus, OH
• Providers in Columbus, OH by specialty
• Community/Retail Pharmacy in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.