Organization · NPI-2

Kroger Texas L P

Pharmacy, Community/Retail Pharmacy · Rockwall, TX

NPI number1568535185
StatusActive
Last updated in NPPESMay 16, 2016

Details

NPI
1568535185
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 codeDescriptionLicenseStatePrimary
3336C0003X Pharmacy, Community/Retail Pharmacy20274TXYes
332B00000X Durable Medical Equipment & Medical Supplies––
333600000X Pharmacy––

Other names

  • Kroger Pharmacy (Doing Business As)

Practice location

2935 Ridge Rd
Rockwall, TX 75032-5804

Phone 972-771-3208 · Fax 972-882-1251

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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