Organization
KROGER LIMITED PARTNERSHIP I
Active
Other names
KROGER PHARMACY J-984
Organization subpart
No
Provider details
NPI number
Authorized official
ALLISON MUENNICH (MANAGER OF PHARMACY LICENSING)
(513) 762-1019
Entity
Organization
Contact information
Practice address
633 ARMOUR RD, BOURBONNAIS, IL 60914-2077
(815) 935-1653
(815) 935-1654
Mailing address
PO BOX 842772, BOSTON, MA 02284-2772
(513) 762-1019
(513) 762-1092
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
054007056
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2023611
PK
—
Enumeration date
09/17/2007
Last updated
05/18/2016
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