Organization
KROGER TEXAS L P
Active
Other names
Kroger Pharmacy #115
Organization subpart
No
Provider details
NPI number
Authorized official
VICTORIA BONE (LICENSING ASP)
(513) 587-5303
Entity
Organization
Contact information
Practice address
9703 BARKER CYPRESS RD, CYPRESS, TX 77433-1214
(281) 746-3645
(281) 746-3647
Mailing address
PO BOX 830242, PHILADELPHIA, PA 19182-0352
(513) 762-1019
(513) 762-1092
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
29335
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2145305
PK
—
05
—
467035
—
TX
Enumeration date
04/16/2014
Last updated
06/24/2025
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