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
2809 N COLUMBIA ST, MILLEDGEVILLE, GA 31061-8465
(478) 414-2145
(478) 414-1135
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
PHRE009783
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003122654A
—
GA
01
—
2131974
PK
—
Enumeration date
09/14/2011
Last updated
03/24/2017
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