Kroger Pharmacy #629

LBN: The Kroger Co
Kroger Pharmacy #629 is an health care organization with primary practice located at 125 E Main St , Cartersville GA 30120-3317. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. The Kroger Co can be contacted via phone (770) 386-8160, or through Muennich, Allison via phone (513) 762-1019.

Contact Information

Primary practice address
125 E Main St Cartersville GA 30120-3317
Fax: (770) 387-0694
Website:
Authorized official contact:
Name: Muennich, Allison

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X 5672 Georgia

Profile Details

NPI number 1043244890
LBN Legal business name The Kroger Co
DBA Doing business as Kroger Pharmacy #629
Authorized official Muennich, Allison
Entity Organization
Organization subpart 1 No
Enumeration date Jul 10th, 2006
Last updated Oct 6th, 2016 - about 8 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1043244890 NPPES
Other 2014471 PK
MEDICAID 00207193A PK

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