KROGER LIMITED PARTNERSHIP I (NPI# 1376791962) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376791962 |
| Entity Type | Organization |
| Organization Name | KROGER LIMITED PARTNERSHIP I |
| Other Organization Name | KROGER PHARMACY |
| Practice Address |
107 Highway 80 E Clinton MS 39056-4738 |
| Mailing Address |
Po Box 842772 Boston MA 02284-2772 |
| Practice Telephone | 6019256343 |
| Practice Fax Number | 6019256344 |
| Mailing Telephone | 5137621019 |
| Mailing Fax Number | 5137621092 |
| Enumeration Date | 2008-09-08 |
| Last Update Date | 2020-03-13 |
| Authorized Official Name | JESSIE WARMAN (MANAGER OF PHARMACY LICENSING) |
| Authorized Official Telephone | 5137621090 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
07866012 | MS | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2116903 | 01 | |
| MS | 03605090 | 05 |
| 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 |
107 HIGHWAY 80 E |
| City | CLINTON |
| State | MS |
| Zip Code | 39056-4738 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881892164 | Stacie Thornton Nelson | Pharmacist | 107 Highway 80 E, Clinton, MS 39056-4738 | 2007-07-06 |
| 1912524018 | Jessica Lariccia | Pharmacist | 107 Highway 80 E, Clinton, MS 39056-4738 | 2020-07-06 |
| 1598304206 | Mary Hathorn | Pharmacist | 107 Highway 80 E, Clinton, MS 39056-4738 | 2019-12-27 |
| 1770122491 | Janna Breland | Pharmacy | 107 Highway 80 E, Clinton, MS 39056-4738 | 2019-12-27 |
| 1467099424 | Joshua Mattox | Pharmacist | 107 Highway 80 E, Clinton, MS 39056-4738 | 2019-12-09 |
| 1821347253 | Morgan Traci Kidd | Pharmacist | 107 Highway 80 E, Clinton, MS 39056-4738 | 2012-08-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376012724 | John Melvin Goolsby Jr. | Dentist | 457 Highway 80 East, Clinton, MS 39056 | 2018-11-15 |
| 1225534530 | Magnolia Allergy Clinic LLC | Internal Medicine | 402 Cynthia St Ste E, Clinton, MS 39056 | 2018-04-04 |
| 1578093704 | Melinda A Weisenberger | Specialist/Technologist | 4600 W Northside Drive, Clinton, MS 39056 | 2017-06-20 |
| 1962859702 | Telehealthone, LLC | Nurse Practitioner | 200 Clinton Plaza, Clinton, MS 39056 | 2016-05-23 |
| 1841686581 | 1st America Infusion Services LLC | Durable Medical Equipment & Medical Supplies | 132 Fairmont Street, Suite B, Clinton, MS 39056 | 2015-04-09 |
| 1023412822 | Rebecca Brooks Prewitt | Social Worker | 130 B Fairmont Street, Clinton, MS 39056 | 2014-10-22 |
| 1396184149 | Robert Joseph Hargis | Urology | 116 Afton Way, Clinton, MS 39056 | 2013-06-14 |
| 1750626321 | Clinton Dental Care, Inc. | Dentist | 736 Clinton Pkwy, Clinton, MS 39056 | 2012-12-07 |
| 1922394469 | Daphenia C. Knight Starling | Nurse Practitioner | Clinton Healthcare, 1251 Pinehaven Rd, Clinton, MS 39056 | 2011-06-23 |
| 1134443385 | Gwendolyn Coleman Garror | Pharmacist | 132 Fairmount Drive, Clinton, MS 39056 | 2010-03-17 |
| Find all providers in zip 39056 | ||||
| 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 |
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| 1568902427 | Clinton Pharmacy LLC | Pharmacy | 119 E Clay St, Clinton, KY 42031-1222 | 2017-02-26 |
| 1063965101 | Jcm Enterprises Inc | Pharmacy | 910 N Charles G Seivers Blvd, Clinton, TN 37716-3816 | 2016-07-25 |
| 1154702900 | Hunts Mill Pharmacy Inc | Pharmacy | 14 Main St Fl 1, Clinton, NJ 08809 | 2015-06-17 |
| 1053702860 | Wal-mart Stores East Lp | Pharmacy | 9181 Highway 67, Clinton, LA 70722-4919 | 2015-02-16 |
| 1134543440 | Physicans Rx Pharmacy of Clinton Inc | Pharmacy | 9131 Piscataway Rd Ste 670, Clinton, MD 20735-2579 | 2014-02-06 |
| 1609216498 | Dirigo Drug LLC | Pharmacy | 1144 Main Street, Clinton, ME 04927 | 2013-06-26 |
| 1487942298 | Wagner Pharmacy Company | Pharmacy | 1726 N. 2nd Street, Clinton, IA 52732 | 2011-07-13 |
| 1184883019 | Walgreen Co | Pharmacy | 9001 Woody Ter Ste B, Clinton, MD 20735-4256 | 2008-06-05 |
| 1437362209 | Clinton Drugstore | Pharmacy | 1027 St Helena, Clinton, LA 70722-1027 | 2007-05-08 |
| Find all providers in CLINTON | ||||
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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.