Organization
KROGER TEXAS L P
Active
Other names
Coushatta Family Medical Center Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
KARLA LANGWORTHY (MANAGER OF PHARMACY CREDENTIALING)
(513) 698-1878
Entity
Organization
Contact information
Practice address
287 PANTHER TRAIL DRIVE, KINDER, LA 70648
(337) 738-3095
(337) 738-3163
Mailing address
1014 VINE ST, CINCINNATI, OH 45202-1141
(513) 698-1878
(513) 762-1092
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
006431
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2132006
PK
—
Enumeration date
09/21/2011
Last updated
04/07/2014
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