Provider Information for 1720012610
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THE KROGER CO
Other Names:Doing Business As:KROGER PHARMACYOrganization Subpart: NO
NPI: 1720012610
Last Updated: 2016-05-16
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Details
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NPI | 1720012610 | ||||||||||||||||
Enumeration Date | 2006-07-10 | ||||||||||||||||
NPI Type | NPI-2 Organization | ||||||||||||||||
Status | Active | ||||||||||||||||
Authorized Official Information | Name: ALLISON MUENNICH Title: MANAGER OF PHARMACY LICENSING Phone: 5137621019 | ||||||||||||||||
Mailing Address | PO BOX 842772 BOSTON, MA 02284-2772 United States Phone: 513-762-1019 | Fax:513-762-1092 | ||||||||||||||||
Primary Practice Address | 6555 SUGARLOAF PKWY STE 200 DULUTH, GA 30097-4929 United States Phone: 770-418-2398 | Fax:770-814-9168 | ||||||||||||||||
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