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
2960 SHALLOWFORD RD, MARIETTA, GA 30066-3094
(770) 977-3640
(770) 977-5464
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
8510
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00913206C
—
GA
01
—
2014379
PK
—
Enumeration date
07/10/2006
Last updated
05/16/2016
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