Organization
KROGER CO OF MICHIGAN
Active
Other names
Kroger Pharmacy #774
Organization subpart
No
Provider details
NPI number
Authorized official
ALLISON MUENNICH (MANAGER OF PHARMACY LICENSING)
(513) 762-1019
Entity
Organization
Contact information
Practice address
20891 E 13 MILE RD, ROSEVILLE, MI 48066-4530
(586) 298-3855
(586) 298-3857
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
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301010765
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2154197
PK
—
Enumeration date
09/21/2015
Last updated
09/19/2025
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