# KROGER LIMITED PARTNERSHIP I

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Kroger Pharmacy \#499
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013297548
- **Authorized official:** ALLISON MUENNICH (MANAGER OF PHARMACY LICENSING)
- **Authorized official phone:** (513) 762-1019

## Contact information

- **Practice address:** 3926 GOODMAN RD W, HORN LAKE, MS 38637-1324
- **Practice address phone:** (662) 393-7868
- **Practice address fax:** (662) 393-1076
- **Mailing address:** PO BOX 842772, BOSTON, MA 02284-2772
- **Mailing address phone:** (513) 762-1019
- **Mailing address fax:** (513) 762-1092

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 05036 | MS | Yes |

## Other

- **Enumeration date:** 08/29/2011
- **Last updated:** 03/23/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 07451752 | — | MS |
| 01 | — | 2131578 | PK | — |