Organization
KROGER LIMITED PARTNERSHIP I
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALLISON MUENNICH (MANAGER OF PHARMACY LICENSING)
(513) 762-1019
Entity
Organization
Contact information
Practice address
180 RED OAKS SC, RONCEVERTE, WV 24970
(304) 645-0310
(304) 645-0312
Mailing address
P.O. BOX 842772, BOSTON, MA 02284
(513) 762-1019
(513) 762-1092
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
MP0552364
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2111740
PK
—
05
—
3810012364
—
WV
Enumeration date
06/19/2008
Last updated
04/20/2018
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