Organization
KROGER TEXAS LP
Active
Other names
Kroger Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
BRYON COOLEY (PHARMACY MERCHANDISER)
(713) 507-6276
Entity
Organization
Contact information
Practice address
10250 STATE HWY 6, FRESNO, CA 77545
(713) 507-6266
(713) 422-8031
Mailing address
PO BOX 677516, DALLAS, TX 75267-7516
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
26082
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5632066
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
10/02/2008
Last updated
10/02/2008
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