Kroger Co Of Michigan
Pharmacy, Community/Retail Pharmacy in Macomb, MI. Organization (NPI-2).
NPI number1720220197
StatusActive
Last updated in NPPESJan 25, 2019
Details
- NPI
- 1720220197
- Entity type
- Organization (NPI-2)
- Legal business name
- Kroger Co Of Michigan
- Organization subpart
- No
- Enumeration date
- Apr 1, 2009
- Last updated
- Jan 25, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3336C0003X | Pharmacy, Community/Retail Pharmacy | 5301009070 | MI | Yes |
| 332B00000X | Durable Medical Equipment & Medical Supplies | – | – |
Other names
- Kroger Pharmacy (Doing Business As)
Practice location
16450 26 Mile RdMacomb, MI 48042-1056
Phone 586-677-8730 · Fax 586-677-8735
Mailing address
Po Box 842772Boston, MA 02284-2772
Phone 513-762-1019 · Fax 513-762-1092
Authorized official
Jessie Warman
Manager Rx Licensing
5137621090
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All 12 Community/Retail Pharmacy providers in Macomb · All 857 providers in Macomb
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