Organization
KROGER LIMITED PARTNERSHIP I
Active
Other names
Kroger Pharmacy #494
Organization subpart
No
Provider details
NPI number
Authorized official
ALLISON MUENNICH (MANAGER OF PHARMACY LICENSING)
(513) 762-1019
Entity
Organization
Contact information
Practice address
7045 OLD CANTON RD, RIDGELAND, MS 39157-1036
(601) 856-0977
(601) 856-1492
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
—
—
3336C0003X
Community/Retail Pharmacy
Primary
03594/01.2
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03654547
—
MS
01
—
2123913
PK
—
Enumeration date
03/01/2010
Last updated
05/16/2016
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