Organization
KROGER TEXAS L P
Active
Other names
KROGER PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
VICTORIA LYNN ANDREWS (MANAGER OF LICENSING)
(937) 728-8628
Entity
Organization
Contact information
Practice address
6200 HIGHWAY 6 SOUTH, MISSOURI CITY, TX 77459-3803
(281) 208-1741
(281) 208-1744
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
20200
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2096127
PK
—
05
—
464566
—
TX
Enumeration date
11/15/2006
Last updated
12/15/2021
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