Organization
KROGER LIMITED PARTNERSHIP I
Active
Other names
Kroger Pharmacy #497
Organization subpart
No
Provider details
NPI number
Authorized official
ALLISON MUENNICH (MANAGER OF PHARMACY LICENSING)
(513) 762-1019
Entity
Organization
Contact information
Practice address
143 FRIENDLY AND FRESH DR, FLOWOOD, MS 39232-6615
(601) 992-6873
(601) 992-9615
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
03987/01.2
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01572046
—
MS
01
—
2123914
PK
—
Enumeration date
03/01/2010
Last updated
05/16/2016
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