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Organization

KROGER LIMITED PARTNERSHIP I

Active
Other names
KROGER PHARMACY
Organization subpart
No

Provider details

NPI number
Authorized official
ALLISON MUENNICH (MANAGER OF PHARMACY LICENSING)
(513) 762-1019
Entity
Organization

Contact information

Practice address
1880 E 2ND ST, DEFIANCE, OH 43512-2502
(419) 782-8079
(419) 784-9140
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
333600000X
Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary
021047100
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0613956
OH
01
2076669
PK
Enumeration date
11/15/2006
Last updated
05/16/2016
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