Organization · NPI-2

Kroger Texas L P

Pharmacy, Community/Retail Pharmacy · Addison, TX

NPI number1124191655

StatusActive

Last updated in NPPESMay 16, 2016

Details

NPI: 1124191655
Entity type: Organization (NPI-2)
Legal business name: Kroger Texas L P
Organization subpart: No
Enumeration date: Nov 15, 2006
Last updated: May 16, 2016

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
3336C0003X	Pharmacy, Community/Retail Pharmacy	22626	TX	Yes
333600000X	Pharmacy	–	–
332B00000X	Durable Medical Equipment & Medical Supplies	–	–

Other names

Kroger Pharmacy (Doing Business As)

Practice location

3770 Belt Line Rd
Addison, TX 75001-4301

Phone 972-620-0349 · Fax 972-620-1684

Mailing address

Po Box 842772
Boston, MA 02284-2772

Phone 513-762-1019 · Fax 513-762-1092

Authorized official

Allison Muennich
Manager Of Pharmacy Licensing
5137621019

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