Organization · NPI-2

Kroger Texas L P

Pharmacy, Community/Retail Pharmacy · Galveston, TX

NPI number1578636007

StatusActive

Last updated in NPPESMay 16, 2016

Details

NPI: 1578636007
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	20179	TX	Yes
332B00000X	Durable Medical Equipment & Medical Supplies	–	–
333600000X	Pharmacy	–	–

Other names

Kroger Pharmacy (Doing Business As)

Practice location

5730 Seawall Blvd
Galveston, TX 77551-5880

Phone 409-741-9091 · Fax 409-741-1966

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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