Organization
THE KROGER CO
Active
Other names
KROGER PHARMACY #697
Organization subpart
No
Provider details
NPI number
Authorized official
ALLISON MUENNICH (MANAGER OF PHARMACY LICENSING)
(513) 762-1019
Entity
Organization
Contact information
Practice address
318 MALL BLVD STE 100, SAVANNAH, GA 31406-4797
(912) 200-9165
(912) 200-9166
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
PHRE009992
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003144430A
—
GA
01
—
2143755
PK
—
Enumeration date
01/08/2014
Last updated
10/03/2017
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