Organization
KROGER TEXAS LP
Active
Other names
Kroger Pharmacy #592
Organization subpart
No
Provider details
NPI number
Authorized official
ALLISON BREDESTEGE (MANAGER OF PHARMACY LICENSING)
(513) 762-1263
Entity
Organization
Contact information
Practice address
5101 W SUBLETT RD, ARLINGTON, TX 76017-1178
(513) 762-1019
(513) 762-1092
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
31974
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2176216
PK
—
Enumeration date
02/08/2018
Last updated
09/19/2025
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