Organization
KROGER LIMITED PARTNERSHIP I
Active
Other names
KROGER PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ALLISON MUENNICH (MANAGER OF PHARMACY LICENSING)
(513) 762-1019
Entity
Organization
Contact information
Practice address
1805 W STATE OF FRANKLIN RD, JOHNSON CITY, TN 37604-8801
(423) 929-1409
(423) 929-1442
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
C3545
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1455051
—
TN
01
—
2093118
PK
—
Enumeration date
07/10/2006
Last updated
05/16/2016
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