Organization
KROGER TEXAS LP
Active
Other names
Kroger Pharmacy #984
Organization subpart
No
Provider details
NPI number
Authorized official
VICTORIA BONE (LICENSING ASP)
(513) 587-5303
Entity
Organization
Contact information
Practice address
2721 SAM RAYBURN HWY, MELISSA, TX 75454-1006
(469) 645-4968
(469) 617-2841
Mailing address
PO BOX 842772, BOSTON, MA 02284-2772
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
05/28/2024
Last updated
05/30/2025
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