KROGER LIMITED PARTNERSHIP I (NPI# 1417020033) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417020033 |
| Entity Type | Organization |
| Organization Name | KROGER LIMITED PARTNERSHIP I |
| Other Organization Name | KROGER PHARMACY J-918 |
| Practice Address |
9219 N Lindbergh Dr Peoria IL 61615-1425 |
| Mailing Address |
Po Box 842772 Boston MA 02284-2772 |
| Practice Telephone | 3096920473 |
| Practice Fax Number | 3096920583 |
| Mailing Telephone | 5137621019 |
| Mailing Fax Number | 5137621092 |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2016-05-18 |
| Authorized Official Name | ALLISON MUENNICH (MANAGER OF PHARMACY LICENSING) |
| Authorized Official Telephone | 5137621019 |
| 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 |
054013756 | IL | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2023921 | 01 |
| Other Name | Type Code |
|---|---|
| KROGER PHARMACY J-918 | 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 |
| Oklahoma Business Registrations | KROGER LIMITED PARTNERSHIP II | 1014 Vine St, Cincinnati, OH 45202 |
| Street Address |
9219 N LINDBERGH DR |
| City | PEORIA |
| State | IL |
| Zip Code | 61615-1425 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467098061 | Vi Ho | Pharmacist | 9219 N Lindbergh Dr, Peoria, IL 61615-1425 | 2019-11-19 |
| 1023654605 | Jeffery Tyler Giebelhausen | Pharmacist | 9219 N Lindbergh Dr, Peoria, IL 61615-1425 | 2019-11-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124627906 | Lance Jay Bucher | Occupational Therapist | 8600 Il-91, Peoria, IL 61615 | 2020-10-22 |
| 1093327496 | Angela Mitchell | Speech-Language Pathologist | 3903 W Ridgeview Dr, Peoria, IL 61615 | 2020-08-18 |
| 1578110680 | Emily E Buenting | Audiologist | 8600 Il Route 91, Suite 300, Peoria, IL 61615 | 2019-08-22 |
| 1730655572 | Sylwia M. Budzik | Physician Assistant | 8600 Illinois Rt. 91, Suite 300, Peoria, IL 61615 | 2018-10-19 |
| 1487169207 | Heather Hart | Registered Nurse | 9016 N. Scrimshaw Dr. Apt 104, Peoria, IL 61615 | 2017-12-04 |
| 1528586849 | Leanne Runyon | Speech-Language Pathologist | 10723 Collett Dr., Peoria, IL 61615 | 2017-09-07 |
| 1467974196 | Elizabeth A Mcleod | Nurse Practitioner | 8600 Illinois Route 91, Suite 130, Peoria, IL 61615 | 2017-07-14 |
| 1790223022 | Janet Warner | Counselor | 8914 North Prarie Court, Peoria, IL 61615 | 2017-02-07 |
| 1437524022 | Brooke Bisping | Dietitian, Registered | 7610 North Orange Prairie Road, Peoria, IL 61615 | 2015-12-08 |
| 1003292111 | Crystal Ann Casper | Dietitian, Registered | 7610 N Orange Prarie Road, Peoria, IL 61615 | 2015-07-31 |
| Find all providers in zip 61615 | ||||
| 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 |
|---|---|---|---|---|
| 1831573021 | Hy Vee Inc | Pharmacy | 7610 N Orange Prairie Road, Peoria, IL 61615 | 2015-07-17 |
| 1184842718 | Harbor Vista | Pharmacy | 9133 W Thunderbird, #102, Peoria, AZ 85381 | 2007-04-20 |
| 1053415943 | German Dobson Cvs, L.L.C. | Pharmacy | 7530 W Cactus Rd, Peoria, AZ 85381-5202 | 2006-09-12 |
| 1750485645 | Cvs 3745 Peoria LLC | Pharmacy | 10727 W Olive Ave, Peoria, AZ 85345-9202 | 2006-09-12 |
| 1831293729 | German Dobson Cvs, L.L.C. | Pharmacy | 8332 W Thunderbird Rd, Peoria, AZ 85381-4822 | 2006-09-12 |
| 1093818866 | Highland Park Cvs, L.L.C. | Pharmacy | 3015 N Sterling Ave, Peoria, IL 61604-2259 | 2006-09-07 |
| 1114020880 | Highland Park Cvs, L.L.C. | Pharmacy | 9315 N Lindbergh Dr, Peoria, IL 61615-1454 | 2006-09-07 |
| 1053350439 | Albertsons LLC | Pharmacy | 7575 W Cactus Rd, Peoria, AZ 85381-5201 | 2006-06-04 |
| 1578513834 | Bogard Drug No. 5, Inc. | Pharmacy | 1102 S Western Ave, Peoria, IL 61605-3356 | 2006-05-10 |
| 1881000339 | Westgaterx Pharmacy | Pharmacy | 8914 N 91st Ave, S 100c, Peoria, AZ 85345-8396 | 2014-07-04 |
| Find all providers in PEORIA | ||||
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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.