KROGER TEXAS LP NPI 1417212820

NPI Information

  • NPI: 1417212820
  • Provider Name: KROGER TEXAS LP
  • Classification: Pharmacy - 3336C0003X
  • Specialization: Community/Retail Pharmacy
  • Entity Type: Organization
  • Doing Business As: KROGER PHARMACY
  • CLIA Number: 45D2052095
  • Address: 4241 CAPITOL AVE
    DALLAS, TX
    ZIP 75204
  • Phone: (972) 338-3101

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NPI Details

KROGER TEXAS LP is a community/retail pharmacy pharmacy in Dallas, TX. The provider is a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. KROGER TEXAS LP NPI is 1417212820. The provider is registered as an organization entity type.
The provider Is Doing Business As Kroger Pharmacy.

The provider's business location address is:

4241 CAPITOL AVE
DALLAS, TX
ZIP 75204-635
Phone: (972) 338-3101
Fax: (972) 338-3103

The provider's authorized official is Allison Muennich .
The authorized official title is Manager Of Pharmacy Licensing and has the following contact phone number (513) 762-1019.

The CLIA number assigned to this NPI record is 45D2052095 - pharmacy with a certificate type of Certificate of Waiver.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Administration of influenza virus vaccine (HCPCS:G0008)
  • Influenza vaccine split virus, preservative free (HCPCS:90662)
  • Adm sarscov2 30mcg/0.3ml bst (HCPCS:0004A)
  • Fee covid-19 vac 13 res (HCPCS:0124A)

The enumeration date for this NPI number is 7/11/2012 and was last updated on 5/16/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1332B00000XDurable Medical Equipment & Medical SuppliesNo
23336C0003XPharmacyCommunity/Retail Pharmacy28134TEXASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1PH0426MEDICARE PIN
22135969OTHERPK
31307140243MEDICARE NSC
41307140243MEDICAIDTEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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