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Kroger Limited Partnership I

Pharmacy, Community/Retail Pharmacy in Fort Wayne, IN. Organization (NPI-2).

NPI number1679646293
StatusActive
Last updated in NPPESMay 16, 2016

Details

NPI
1679646293
Entity type
Organization (NPI-2)
Legal business name
Kroger Limited Partnership I
Organization subpart
No
Enumeration date
Nov 15, 2006
Last updated
May 16, 2016

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
3336C0003X Pharmacy, Community/Retail Pharmacy60005169INYes
332B00000X Durable Medical Equipment & Medical Supplies––
333600000X Pharmacy––

Other names

  • Kroger Pharmacy (Doing Business As)

Practice location

218 E Pettit Ave
Fort Wayne, IN 46806-3005

Phone 260-456-4736 · Fax 260-744-5053

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

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

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