Active NPI
Kroger Texas L P
Doing business as Kroger Pharmacy
- Community/Retail Pharmacy
- Fresno, TX
National Provider Identifier
1801048376
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 26082
- Legal business name
- KROGER TEXAS L P
- Doing business as
- Kroger Pharmacy
- Practice address
- 10250 Fresno State Hwy 6
Fresno, TX 77545 - Phone
- (281) 431-6113
- Fax
- (281) 431-6117
- NPI assigned
- Oct 16, 2008
- Last updated
- May 18, 2016
- Organization subpart
- No
NPPES NPI Registry
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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | 26082 | TX | Primary |
Addresses
Primary practice location
10250 Fresno State Hwy 6
Fresno, TX 77545
Mailing address
PO Box 842772
Boston, MA 02284-2772
Phone (513) 762-1019
Other names 1
- Kroger Pharmacy
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20041103001304 | TX | Part B Supplier - Mass Immunization (Roster Biller Only) | 9638131303 | This NPI is an additional NPI on the enrollment |
| O20100930055127 | TX | DME Supplier - Pharmacy | 9638131303 | Practice locations: Fresno, TX |
National Provider Directory
National Provider Directory- Tax ID family
- Kroger Texas
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1224115200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1463529600000",
"number": "1801048376",
"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": "10250 FRESNO STATE HWY 6",
"city": "FRESNO",
"state": "TX",
"postal_code": "77545",
"telephone_number": "281-431-6113",
"fax_number": "281-431-6117"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "KROGER TEXAS L P",
"organizational_subpart": "NO",
"enumeration_date": "2008-10-16",
"last_updated": "2016-05-18",
"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": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "TX",
"license": "26082",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Kroger Pharmacy",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Fresno, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.