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	333600000X	Pharmacy
2	332B00000X	Durable Medical Equipment & Medical Supplies
3	3336C0003X	Community/Retail Pharmacy	20263	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	2092580	OTHER		PK

General Provider Information

NPI Number	:	1982777298
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	:	3305 DALLAS PKWY
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75093-7797
Country	:	US
Telephone Number	:	972-608-4694
Fax Number	:	972-608-4110

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

Provider Enumeration Date	:	11/16/2006
Last Update Date	:	06/27/2016

Similar Medicare Providers

1750980132 — JOSHUA SCOTT FUGATE
Practice Location Address:

3305 DALLAS PKWY
PLANO, TX
75093-7797

Practice Phone: 210-219-5080
Practice Fax:

1437758208 — HAI HOANG RPH
Practice Location Address:

3305 DALLAS PKWY
PLANO, TX
75093-7797

Practice Phone: 972-608-4695
Practice Fax:

1861091563 — GREG WRIGHT
Practice Location Address:

3305 DALLAS PKWY
PLANO, TX
75093-7797

Practice Phone: 972-608-4694
Practice Fax:

1740883305 — THY NGOC THI HOANG
Practice Location Address:

3305 DALLAS PKWY
PLANO, TX
75093-7797

Practice Phone: 972-608-4694
Practice Fax:

1114052362 — ADVANCED COMPREHENSIVE MEDICAL P.A.
Practice Location Address:

4674 MCDERMOTT RD STE 308
PLANO, TX
75024-7797

Practice Phone: 972-424-4243
Practice Fax: 972-424-6211

1295450641 — MISTY AVILA FNP
Practice Location Address:

4674 MCDERMOTT RD STE 308
PLANO, TX
75024-7797

Practice Phone: 972-424-4243
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.