Kroger Texas L P
Organization Active NPI Community/Retail Pharmacy · Cypress, TX
NPI 1972676591 · NPPES record last updated May 16, 2016
Key facts
- NPI
- 1972676591
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- 20230 (TX)
- Legal business name
- KROGER TEXAS L P
- Practice address
- 13135 Louetta Rd
Cypress, TX 77429-5155 - Phone
- (281) 379-7756
- Fax
- (281) 379-7759
- NPI assigned
- Nov 15, 2006
- Organization subpart
- No
Authorized official
- Name
- Allison Muennich
- Title
- Manager of Pharmacy Licensing
- Phone
- (513) 762-1019
Corporate family (same tax ID) 16
Member of 1
Practitioners 3
-
Artesia Aing, PHARM.D.
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 45D1057149 | Kroger Pharmacy 327 | Certificate of waiver | Aug 2, 2026 |
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Kroger Pharmacy #327 |
Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Canes and/or Crutches|Walkers|Ostomy Supplies|Urological Supplies|Enteral Nutrients|Enteral Equipment and/or Supplies|Nebulizer Equipment a… | Accepts assignment |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in TX
Medicare enrollment records
| 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 |
| O20100930074345 | TX | DME Supplier - Pharmacy | 9638131303 | Practice locations: Cypress, TX |
National Provider Directory
- Tax ID family
- Kroger Texas
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | 20230 | TX | Yes |
Addresses
Primary practice location
13135 Louetta Rd
Cypress, TX 77429-5155
Mailing address
PO Box 842772
Boston, MA 02284-2772
Phone (513) 762-1019
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 464561 | Medicaid | TX | |
| 2106687 | Other | PK |
Other names
- KROGER PHARMACY
Other providers in Cypress, TX
- Chelsie J Krobot
- Kroger Texas L P
- Kroger Texas L P
- Kroger Texas L P
- Kroger Texas L P
- Amanda Erin Krueger
- Alyssa Kuban
- Alyssa Briana Kuhn
- Arun Kumar
- Navneet Kumar
All providers in Cypress, TX · Community/Retail Pharmacy in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 16, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.