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Organization

KROGER TEXAS L P

Active
Other names
KROGER PHARMACY #150
Organization subpart
No

Provider details

NPI number
Authorized official
ALLISON MUENNICH (MANAGER OF PHARMACY LICENSING)
(513) 762-1019
Entity
Organization

Contact information

Practice address
6315 GARTH RD, BAYTOWN, TX 77521-9686
(346) 216-4155
(346) 216-4157
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
20191
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2105423
PK
05
464538
TX
Enumeration date
11/15/2006
Last updated
04/26/2017
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