MEDICARE: KROGER TEXAS L P

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	333600000X	Pharmacy
3	3336C0003X	Community/Retail Pharmacy	20280	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2093001	OTHER		PK

General Provider Information

NPI Number	:	1326111840
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KROGER TEXAS L P

Provider Business Mailing Address
First Line	:	PO BOX 842772
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02284-2772
Country	:	US
Telephone Number	:	513-762-1019
Fax Number	:	513-762-1092

Provider Business Practice Location Address
First Line	:	1600 N 16TH ST
Second Line	:
City	:	ORANGE
State	:	TX
Zip	:	77630-3616
Country	:	US
Telephone Number	:	409-886-1362
Fax Number	:	409-886-8216

Authorized Official
Title or Position	:	MANAGER OF PHARMACY LICENSING
Name	:	ALLISON MUENNICH
Credential	:
Telephone Number	:	513-762-1019

Provider Enumeration Date	:	11/15/2006
Last Update Date	:	05/16/2016

Similar Medicare Providers

1174798433 — ORANGE COUNTY NEWBORN MEDICARE CARE PC
Practice Location Address:

3 SAINT STEPHENS PL , SUITE 2
WARWICK, NY
10990-3208

Practice Phone: 845-987-9700
Practice Fax:

1124534573 — DR. BIANCA M PATEL PHARMD
Practice Location Address:

1600 N 16TH ST
ORANGE, TX
77630-3616

Practice Phone: 409-886-1362
Practice Fax:

1376186569 — KYLEE VIDRINE
Practice Location Address:

1600 N 16TH ST
ORANGE, TX
77630-3616

Practice Phone: 409-886-1362
Practice Fax:

1356010995 — TRISHA PATEL
Practice Location Address:

1600 N 16TH ST
ORANGE, TX
77630-3616

Practice Phone: 409-886-1362
Practice Fax:

1528403326 — MARCED, INC
Practice Location Address:

1645 BARTLETT AVE
ORANGE PARK, FL
32073-3616

Practice Phone: 904-264-9570
Practice Fax: 904-264-9570

1437011376 — BRANDON JOUBERT
Practice Location Address:

19 KNOTTY PINE LN
ORANGE, TX
77630-3301

Practice Phone: 409-670-2974
Practice Fax:

Directions to “KROGER TEXAS L P ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.