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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
1070 HIGHWAY 51, MADISON, MS 39110-9084
(601) 856-3275
(601) 856-6347
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
02848012
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00330566
MS
01
2045438
PK
Enumeration date
07/10/2006
Last updated
05/16/2016
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