Provider Information for 1427253756
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KROGER LIMITED PARTNERSHIP I
Other Names:Doing Business As:SCOTTS PHARMACY J 410Organization Subpart: NO
NPI: 1427253756
Last Updated: 2016-05-16
Certification Date:
Certification Date:
Details
Name | Value | ||||||||||||
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NPI | 1427253756 | ||||||||||||
Enumeration Date | 2007-06-18 | ||||||||||||
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 | 7008 BLUFFTON RD FORT WAYNE, IN 46809-2706 United States Phone: 260-747-4136 | Fax:260-747-4137 | ||||||||||||
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