Organization
KROGER LIMITED PARTNERSHIP I
Active
Other names
KROGER PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ALLISON MUENNICH (MANAGER OF PHARMACY LICENSING)
(513) 762-1019
Entity
Organization
Contact information
Practice address
406 JOHN RAINE DR, RAINELLE, WV 25962-1467
(304) 438-7182
(304) 438-7198
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
552258
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2111405
PK
—
05
—
8500085000
—
WV
Enumeration date
07/10/2006
Last updated
09/30/2016
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