KROGER LIMITED PARTNERSHIP I (NPI# 1093749871) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093749871 |
| Entity Type | Organization |
| Organization Name | KROGER LIMITED PARTNERSHIP I |
| Other Organization Name | KROGER PHARMACY |
| Practice Address |
3405 Pemberton Square Blvd Vicksburg MS 39180-5574 |
| Mailing Address |
800 Ridge Lake Blvd Memphis TN 38120-9427 |
| Practice Telephone | 6016383412 |
| Practice Fax Number | 6016383628 |
| Mailing Telephone | 9017654157 |
| Mailing Fax Number | 9017654213 |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2009-06-24 |
| Authorized Official Name | MATT MINEER (INTERFACE MANAGER) |
| Authorized Official Telephone | 5133877074 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
1957012 | MS | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 0330556 | 05 | |
| NCPDP PROVIDER IDENTIFICATION NUMBER | 2514873 | 01 |
| Other Name | Type Code |
|---|---|
| KROGER PHARMACY | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649776477 | Kroger Limited Partnership I | Durable Medical Equipment & Medical Supplies | 1050 W Mercury Blvd, Hampton, VA 23666-3307 | 2018-04-02 |
| 1629574488 | Kroger Limited Partnership I | Durable Medical Equipment & Medical Supplies | 7254 Hayes Shopping Court, Hayes, VA 23072 | 2018-04-02 |
| 1215433271 | Kroger Limited Partnership I | Durable Medical Equipment & Medical Supplies | 1282 Smithfield Plz, Smithfield, VA 23430-6054 | 2018-03-30 |
| 1003312034 | Kroger Limited Partnership I | Durable Medical Equipment & Medical Supplies | 309 S Battlefield Blvd, Chesapeake, VA 23320 | 2018-03-30 |
| 1437655461 | Kroger Limited Partnership I | Durable Medical Equipment & Medical Supplies | 6500 George Washington Mem Hwy Ste C, Grafton, VA 23692 | 2018-03-30 |
| 1740780550 | Kroger Limited Partnership I | Durable Medical Equipment & Medical Supplies | 10679 N Michigan Rd, Zionsville, IN 46077-9261 | 2018-02-19 |
| 1700386521 | Kroger Limited Partnership I | Durable Medical Equipment & Medical Supplies | 715 S Tillotson Ave, Muncie, IN 47304-4526 | 2018-02-19 |
| 1649784174 | Kroger Limited Partnership I | Pharmacy | 5 Boone Vlg, Zionsville, IN 46077-1231 | 2017-11-20 |
| 1255845871 | Kroger Limited Partnership I | Durable Medical Equipment & Medical Supplies | 1500 W Mcgalliard Rd, Muncie, IN 47304-2203 | 2017-11-17 |
| 1649783432 | Kroger Limited Partnership I | Durable Medical Equipment & Medical Supplies | 227 W Michigan St, Indianapolis, IN 46204-1242 | 2017-11-15 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | Kroger Limited Partnership I | 1014 Vine Street, Cincinnati, Ohio 45202 |
| North Carolina Corporations | Kroger Limited Partnership I | 2626 Glenwood Avenue, Suite 550, Raleigh, NC 27608 |
| Indiana Business Entities | KROGER LIMITED PARTNERSHIP I | 1014 Vine St, Cincinnati, OH 45202 |
| Oklahoma Business Registrations | KROGER LIMITED PARTNERSHIP II | 1014 Vine St, Cincinnati, OH 45202 |
| Indiana Business Entities | KROGER LIMITED PARTNERSHIP II | 1014 Vine St, Cincinnati, OH 45202 |
| Street Address |
3405 PEMBERTON SQUARE BLVD |
| City | VICKSBURG |
| State | MS |
| Zip Code | 39180-5574 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255877346 | Elite Performance and Rehab, LLC | Clinic/Center | 1901 A Mission 66, Vicksburg, MS 39180 | 2017-01-12 |
| 1679931083 | Heather M Anderson | Physician Assistant | 2080 S Frontage Rd Ste 100, Vicksburg, MS 39180 | 2016-02-01 |
| 1245604941 | Warren County Assn.for Retarded Citizens, Inc. | Day Training, Developmentally Disabled Services | 100 Smokey Lane, Vicksburg, MS 39180 | 2015-11-18 |
| 1386012904 | Brian Oliver Snowden | Counselor | 3530 Manor Dr Ste 5a, Vicksburg, MS 39180 | 2015-09-14 |
| 1962802710 | Jordan P. Crocker, D.m.d., Pllc | Clinic/Center | 109 Monument Place, Vicksburg, MS 39180 | 2014-08-29 |
| 1821434259 | Trisha Addison | Physical Therapist | 2222 South Frontage Road, Suite D, Vicksburg, MS 39180 | 2013-05-13 |
| 1073862157 | Laura Jeanne Briggs | Physical Therapist | 1901-a Mission 66, Vicksburg, MS 39180 | 2012-09-05 |
| 1912175258 | Andrea T. Harris | Counselor | Warren-yazoo Mental Health Service, 3444 Wisconsin Ave., Vicksburg, MS 39180 | 2008-02-20 |
| 1922217314 | Austin Family Dentistry | Dentist | 3040 Indiana Ave, Vicksburg, MS 39180 | 2007-05-22 |
| 1063539138 | Ollie Hardaway Jr. | Dentist | 154 Cottonwood Street, Vicksburg, MS 39180 | 2007-03-23 |
| Find all providers in zip 39180 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| 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. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982680468 | Freds Super Pharmacy Inc | Pharmacy | 121 W Prairie St, Vicksburg, MI 49097 | 2005-12-16 |
| 1306102470 | Freds Pharmacy of Quitman LLC | Pharmacy | 1123 Washington St, Vicksburg, MS 39183-2959 | 2012-04-03 |
| 1740412964 | Battlefield Express Drugs Incorporated | Pharmacy | 2080 S Frontage Rd, Suite 101, Vicksburg, MS 39180-5328 | 2009-08-21 |
| 1922258730 | Battlefield Clinic Drugs | Pharmacy | 2080 S Frontage Rd, Ste N, Vicksburg, MS 39180-5328 | 2008-09-29 |
| 1184670085 | Hill's Pharmacy of Vicksburg, Inc. | Pharmacy | 110 S Main St, Vicksburg, MI 49097-1211 | 2006-05-25 |
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| 1649883844 | Natchez Wellness Pharmacy | Pharmacy | 29 Sergeant Prentiss Dr Ste 5, Natchez, MS 39120-4743 | 2020-08-26 |
| 1952910366 | Ct Stamps Inc | Pharmacy | 206 Marion Avenue, Mccomb, MS 39648 | 2020-07-31 |
| 1114566122 | Valley Drugs, Inc. | Pharmacy | 327b S Main St, Water Valley, MS 38965-3318 | 2019-12-23 |
| 1851939318 | Smith Pharmacy, Inc. | Pharmacy | 306 Northside Drive, Newton, MS 39345 | 2019-12-16 |
| 1285270801 | Proxsys Rx - Rush LLC | Pharmacy | 14916 Hwy 16 W, Unit #1, Dekalb, MS 39328 | 2019-11-19 |
| 1518501592 | Southwest Pharmacy Inc | Pharmacy | 3000 Plaza Dr Ste B, Tylertown, MS 39667-9227 | 2019-11-01 |
| 1669015210 | Hometown Family Pharmacy, Inc. | Pharmacy | 930 Hall St Ste H, Wiggins, MS 39577-2113 | 2019-10-25 |
| 1225671001 | A & A Infusion & Specialty, LLC | Pharmacy | 124 E Jackson St, Belzoni, MS 39038-3642 | 2019-10-23 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.