Organization
KROGER LIMITED PARTNERSHIP I
Active
Other names
Kroger Pharmacy J-66
Organization subpart
No
Provider details
NPI number
Authorized official
ALLISON MUENNICH (MANAGER OF PHARMACY LICENSING)
(513) 762-1019
Entity
Organization
Contact information
Practice address
5173 W WASHINGTON ST, INDIANAPOLIS, IN 46241-2205
(317) 381-9659
(317) 381-9678
Mailing address
5173 W WASHINGTON ST, INDIANAPOLIS, IN 46241-2205
(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
60005712
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200406990A
—
IN
01
—
2024601
PK
—
Enumeration date
11/15/2006
Last updated
06/13/2016
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