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
201 S MAIN ST, EAST PEORIA, IL 61611-2458
(309) 694-6451
(309) 694-6453
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
054008814
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2018962
PK
—
Enumeration date
11/15/2006
Last updated
05/18/2016
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