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Organization

KROGER LIMITED PARTNERSHIP I

Active
Other names
Kroger Pharmacy #777
Organization subpart
No

Provider details

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

Contact information

Practice address
523 N 6TH ST, BLYTHEVILLE, AR 72315-2407
(870) 762-2024
(870) 763-3240
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
AR00856
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2154712
PK
Enumeration date
10/16/2015
Last updated
05/16/2016
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