Kroger Texas L P

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

22626 Issued in TX

Legal business name

KROGER TEXAS L P

Practice address

3770 Belt Line Rd
Addison, TX 75001-4301

Phone

(972) 620-0349

Fax

(972) 620-1684

NPI assigned

Nov 15, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Allison Muennich

Title

Manager of Pharmacy Licensing

Phone

(513) 762-1019

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• KROGER PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in TX2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Medicare medical equipment & supply locations

Tax ID family

Kroger Texas201 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

• Kroger Texas L P

  • Community/Retail Pharmacy
  • Katy, TX
  • NPI 1063585388
  NPD tax ID
• Kroger Texas L P

  • Community/Retail Pharmacy
  • Missouri City, TX
  • NPI 1063585586
  NPD tax ID
• Kroger Texas L P

  • Community/Retail Pharmacy
  • Houston, TX
  • NPI 1063585685
  NPD tax ID
• Kroger Texas L P

  • Community/Retail Pharmacy
  • Baytown, TX
  • NPI 1073686697
  NPD tax ID
• Kroger Texas L P

  • Community/Retail Pharmacy
  • Arlington, TX
  • NPI 1083787600
  NPD tax ID
• Kroger Texas L P

  • Community/Retail Pharmacy
  • League City, TX
  • NPI 1093888315
  NPD tax ID
• Kroger Texas L P

  • Community/Retail Pharmacy
  • Irving, TX
  • NPI 1093888521
  NPD tax ID
• Kroger Texas L P

  • Community/Retail Pharmacy
  • Cedar Hill, TX
  • NPI 1104999721
  NPD tax ID
• Kroger Texas L P

  • Community/Retail Pharmacy
  • Flower Mound, TX
  • NPI 1114090420
  NPD tax ID
• Kroger Texas L P

  • Community/Retail Pharmacy
  • Plano, TX
  • NPI 1114090644
  NPD tax ID
• Kroger Texas L P

  • Community/Retail Pharmacy
  • Carrollton, TX
  • NPI 1124052865
  NPD tax ID
• Kroger Texas L P

  • Community/Retail Pharmacy
  • Houston, TX
  • NPI 1124191648
  NPD tax ID

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• The Kroger Co

  • Community/Retail Pharmacy
  • Woodstock, GA
  • NPI 1720012560

  Member Of

  NPD member

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Amy Tan

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Addison, TX
  • NPI 1609475045
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463356800000",
    "number": "1124191655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 842772",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022842772",
            "telephone_number": "513-762-1019",
            "fax_number": "513-762-1092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3770 BELT LINE RD",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "750014301",
            "telephone_number": "972-620-0349",
            "fax_number": "972-620-1684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KROGER TEXAS L P",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2016-05-16",
        "status": "A",
        "authorized_official_last_name": "MUENNICH",
        "authorized_official_first_name": "ALLISON",
        "authorized_official_title_or_position": "MANAGER OF PHARMACY LICENSING",
        "authorized_official_telephone_number": "513-762-1019"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "22626",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2098772",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "465376",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KROGER PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Makenzie Jane Koehn, D.C.
• Kelsie Lynn Koenig, M.ED., BCBA, LBA
• Mackenzie Kohler
• Diana C Koutinas, C.N.I.M., R.EP T
• Dolores Kraft, PH.D.
• Matthew Kron, M.D.
• Terry Ku, DDS
• Stephen Kuclo, IHP L2, HPH, EMT-P
• Kurtin Vision Specialists
• Steven Charles Kurtin, DO

• All providers in Addison, TX
• Community/Retail Pharmacy in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.