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	20255	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2103892	OTHER		PK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1538232061
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	:	2475 ASCENSION BLVD
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76006-4205
Country	:	US
Telephone Number	:	817-275-2901
Fax Number	:	817-860-6499

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

1134728058 — JOYCE NATVIG
Practice Location Address:

2475 ASCENSION BLVD
ARLINGTON, TX
76006-4205

Practice Phone: 817-275-2901
Practice Fax:

1073629341 — JEAN ANN BAGEL ATC
Practice Location Address:

2121 S GOEBBERT RD
ARLINGTON HEIGHTS, IL
60005-4205

Practice Phone: 847-718-4176
Practice Fax:

1669570065 — MR. EDGAR URZUA LCSW
Practice Location Address:

2121 S GOEBBERT RD
ARLINGTON HEIGHTS, IL
60005-4205

Practice Phone: 847-718-7782
Practice Fax: 847-718-7773

1801927371 — TOWNSHIP HIGH SCHOOL DISTRICT 214
Practice Location Address:

2121 GOEBBERT RD
ARLINGTON HEIGHTS, IL
60005-4205

Practice Phone: 847-718-7657
Practice Fax:

1871858365 — MS. PATRICIA BENITEZ LCSW
Practice Location Address:

4205 GLEN HOLLOW CIR
ARLINGTON, TX
76016-4914

Practice Phone: 817-262-2631
Practice Fax:

1285037051 — CONSTANCE SMITH CPNP, RN
Practice Location Address:

4205 CYPRESS SPRINGS DR
ARLINGTON, TX
76001-5104

Practice Phone: 817-478-4674
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 © 2007-2026 (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.