Organization
KROGER LIMITED PARTNERSHIP I
Active
Other names
Kroger Pharmacy #499
Organization subpart
No
Provider details
NPI number
Authorized official
ALLISON MUENNICH (MANAGER OF PHARMACY LICENSING)
(513) 762-1019
Entity
Organization
Contact information
Practice address
3926 GOODMAN RD W, HORN LAKE, MS 38637-1324
(662) 393-7868
(662) 393-1076
Mailing address
PO BOX 842772, BOSTON, MA 02284-2772
(513) 762-1019
(513) 762-1092
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
05036
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07451752
—
MS
01
—
2131578
PK
—
Enumeration date
08/29/2011
Last updated
03/23/2017
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