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Organization

KROGER CO OF MICHIGAN

Active
Other names
Kroger Pharmacy #754
Organization subpart
No

Provider details

NPI number
Authorized official
ALLISON MUENNICH (MANAGER OF PHARMACY LICENSING)
(513) 762-1263
Entity
Organization

Contact information

Practice address
7644 26 MILE RD, SHELBY TOWNSHIP, MI 48316-5007
(586) 697-8240
(586) 697-8242
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

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1346791183
MI
01
2166098
PK
Enumeration date
10/17/2016
Last updated
01/20/2017
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