KROGER LIMITED PARTNERSHIP I (NPI# 1598799306) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598799306 |
| Entity Type | Organization |
| Organization Name | KROGER LIMITED PARTNERSHIP I |
| Other Organization Name | KROGER PHARMACY |
| Practice Address |
1609 S Park Ave Herrin IL 62948-4162 |
| Mailing Address |
Po Box 842772 Boston MA 02284-2772 |
| Practice Telephone | 6189881649 |
| Practice Fax Number | 6189886741 |
| Mailing Telephone | 5137621019 |
| Mailing Fax Number | 5137621092 |
| Enumeration Date | 2006-07-10 |
| 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 |
54011930 | IL | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2022826 | 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 |
1609 S PARK AVE |
| City | HERRIN |
| State | IL |
| Zip Code | 62948-4162 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992304851 | Celeste Marie Batts | Pharmacist | 1609 S Park Ave, Herrin, IL 62948-4162 | 2020-10-21 |
| 1710518014 | Lindsey Disbrow | Pharmacist | 1609 S Park Ave, Herrin, IL 62948-4162 | 2020-01-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215307590 | Carmelito Miralles Caronongan | Pediatrics | 120 S. 11th St., Herrin, IL 62948 | 2015-09-30 |
| 1073995684 | Motaz R Wraikat | Preventive Medicine | 315 S 13th St Ste 3, Herrin, IL 62948 | 2015-06-19 |
| 1639427933 | Salim Hosein | Surgery | 317 S 14th St Ste 1, Herrin, IL 62948 | 2012-08-17 |
| 1962780288 | Pooja Sareen | Internal Medicine | 3024 S Park Avenue, Herrin, IL 62948 | 2011-08-03 |
| 1235459918 | Timoteo Castro Md & Josefina D. Castro Md Ltd | Family Medicine | 321 South 13st St., Herrin, IL 62948 | 2010-06-04 |
| 1457501926 | Don Cassidy Arnold II | Urology | 220 S Park Ave Fl 2, Herrin, IL 62948 | 2008-09-22 |
| 1306094560 | Karl Keith Mitchener | Speech-Language Pathologist | 1901 N 13th Street, Herrin, IL 62948 | 2008-08-29 |
| 1457509705 | Kathryn Marie Bordenet-jines | Occupational Therapy Assistant | 1901 N. 13th, Herrin, IL 62948 | 2008-08-28 |
| 1417105776 | Cheryl Lynn Matic | Occupational Therapy Assistant | 1901 N. 13th St., Herrin, IL 62948 | 2008-08-28 |
| 1174771422 | Mary Frances Graham | Physical Therapy Assistant | 1901 N. 13th Street, Herrin, IL 62948 | 2008-08-28 |
| Find all providers in zip 62948 | ||||
| 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 |
|---|---|---|---|---|
| 1366535700 | Moroni Drugs Inc | Pharmacy | 109 W Monroe St, Herrin, IL 62948-1743 | 2006-09-30 |
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|---|---|---|---|---|
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| 1952909632 | Cordant Pharmacy Illinois, LLC | Pharmacy | 8623 W Bryn Mawr Ave Ste 504, Chicago, IL 60631-3525 | 2020-10-14 |
| 1386242352 | Letitride, Inc. | Pharmacy | 501 W Oak Street, Fairbury, IL 61739 | 2020-10-13 |
| 1699389890 | J2sb LLC | Pharmacy | 398 W Army Trail Rd Ste 120, Bloomingdale, IL 60108-2398 | 2020-09-04 |
| 1891308045 | Apotheco Pharmacy Lincoln Park LLC | Pharmacy | 2140 N Halsted St, Chicago, IL 60614-4385 | 2020-08-27 |
| 1982217345 | Costco Wholesale Corporation | Pharmacy | 2002 N. Neil St., Champaign, IL 61820 | 2020-08-26 |
| 1710599485 | Costco Wholesale Corporation | Pharmacy | 16261 S Boulevard Pl, Plainfield, IL 60586-4400 | 2020-08-23 |
| 1982212635 | Grand Pharmacy LLC | Pharmacy | 229 W Grand Ave Ste F, Bensenville, IL 60106-3365 | 2020-07-20 |
| 1871110254 | Illini Clinic Pharmacy Inc | Pharmacy | 103 N Prospect St, Cambridge, IL 61238-1148 | 2020-07-01 |
| 1831716745 | The Project of The Quad Cities | Pharmacy | 1701 River Dr Ste 106, Moline, IL 61265-1384 | 2020-06-26 |
| 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.