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Contact Information

THE KROGER CO
9484 ELLERBE RD STE 100
SHREVEPORT, LA71106
 Phone: 318-517-6973
 Fax: 318-517-6976
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
 

Durable Medical Equipment & Medical Supplies

332B00000X 54 Other Medical Supply Company
 

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for THE KROGER CO

NPI # 1548611288
LBN Legal business name THE KROGER CO
Authorized official JESSIE WARMAN - (MANAGER OF PHARMACY LICENSING)
Entity Organization
Organization subpart 1 No
Enumeration date 06/23/2016
Last updated 07/20/2018 - About 8 years ago
Identifiers
LA License # PHY.007389-RC
LA Medicaid 2204840
Other 2160807 PK
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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