Organization
THE KROGER CO
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
1284 KNOX AVE, NORTH AUGUSTA, SC 29841-4055
(803) 442-4510
(803) 442-4515
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
10202
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2117668
PK
—
05
—
710202
—
SC
Enumeration date
11/05/2008
Last updated
06/28/2016
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