Organization
KROGER LIMITED PARTNERSHIP I
Active
Other names
Payless Pharmacy #336, Kroger Pharmacy #336
Organization subpart
No
Provider details
NPI number
Authorized official
ALLISON MUENNICH (MANAGER OF PHARMACY LICENSING)
(513) 762-1263
Entity
Organization
Contact information
Practice address
1500 W MCGALLIARD RD, MUNCIE, IN 47304-2203
(765) 741-1494
(765) 741-1496
Mailing address
PO BOX 842772, BOSTON, MA 02284-2772
(513) 762-1019
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
60006647A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2173890
PK
—
Enumeration date
11/17/2017
Last updated
01/31/2018
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