KROGER LIMITED PARTNERSHIP I (NPI# 1669497384) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669497384 |
| Entity Type | Organization |
| Organization Name | KROGER LIMITED PARTNERSHIP I |
| Other Organization Name | KROGER PHARMACY |
| Practice Address |
41 Stonebrook Pl Jackson TN 38305-3637 |
| Mailing Address |
Po Box 842772 Boston MA 02284-2772 |
| Practice Telephone | 7316610912 |
| Practice Fax Number | 7316610914 |
| Mailing Telephone | 5137621019 |
| Mailing Fax Number | 5137621092 |
| Enumeration Date | 2006-07-13 |
| 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 | ||
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
C2300 | TN | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 9449764 | 05 | |
| PK | 2091305 | 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 |
41 STONEBROOK PL |
| City | JACKSON |
| State | TN |
| Zip Code | 38305-3637 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982073268 | Holly Wilkerson | Pharmacist | 41 Stonebrook Pl, Jackson, TN 38305-3637 | 2015-09-17 |
| 1417325820 | Jason Greer | Pharmacist | 41 Stonebrook Pl, Jackson, TN 38305-3637 | 2015-09-02 |
| 1881070274 | Joshua Mathis | Pharmacist | 41 Stonebrook Pl, Jackson, TN 38305-3637 | 2015-08-07 |
| 1265841258 | Ashley Nicole Pugh | Pharmacist | 41 Stonebrook Pl, Jackson, TN 38305-3637 | 2014-08-05 |
| 1972842417 | Dwight David Ford | Pharmacist | 41 Stonebrook Pl, Jackson, TN 38305-3637 | 2013-02-04 |
| 1790088813 | Kristina Murphy | Pharmacist | 41 Stonebrook Pl, Jackson, TN 38305-3637 | 2010-12-11 |
| 1659672871 | Whitney Gomez | Pharmacist | 41 Stonebrook Pl, Jackson, TN 38305-3637 | 2010-11-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427656818 | Kimaya Jelks | Specialist | 1869 45 Hwy Bypass, Suite 2b, Jackson, TN 38305 | 2020-10-16 |
| 1821600578 | Maame Obeng | Pharmacist | 3144 North Highland Avenue, Jackson, TN 38305 | 2020-08-22 |
| 1700361904 | James Cowie | Psychologist | 156c West University Pkwy, Jackson, TN 38305 | 2018-10-03 |
| 1700372109 | Chad Zawacki | Physician Assistant | 147 North Star Drive, Jackson, TN 38305 | 2018-07-09 |
| 1104323070 | Golden Years Adult Day Care | Clinic/Center | 155 Carriage Dr Suite A, Jackson, TN 38305 | 2018-04-09 |
| 1245754563 | Tanika Annette Gillard | Massage Therapist | 4 Hampton Ln, Jackson, TN 38305 | 2017-07-28 |
| 1316488117 | Lakisha T Ingram | Counselor | 168 Greencastle Dr, Jackson, TN 38305 | 2017-03-13 |
| 1619421567 | D & L Wellness Inc | Community/Behavioral Health | 154 Carriage House Dr., Jackson, TN 38305 | 2016-08-09 |
| 1649637638 | Advance Choice Home Care LLC | In Home Supportive Care | 1028 Ashport Rd., Jackson, TN 38305 | 2016-01-21 |
| 1942666151 | Neurohealth Solutions Inc. | Clinic/Center | 174 Murray Guard Dr. Suite E, Jackson, TN 38305 | 2016-01-05 |
| Find all providers in zip 38305 | ||||
| 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 |
|---|---|---|---|---|
| 1144874868 | Whitney Harris Drugs, Inc. | Pharmacy | 1200 Eastover Dr Ste 175, Jackson, MS 39211-6317 | 2019-07-31 |
| 1013576826 | Avita Drugs Mississippi, LLC | Pharmacy | 805 E River Pl Ste A, Jackson, MS 39202-3486 | 2019-06-06 |
| 1639677230 | Walgreen Co | Pharmacy | 971 Lakeland Dr Ste 101, Jackson, MS 39216 | 2018-01-29 |
| 1952823783 | Teton County Hospital District | Pharmacy | 555 E Broadway Ave Ste 212, Jackson, WY 83001-8640 | 2017-07-13 |
| 1477955037 | Jackson Village Pharmacy LLC | Pharmacy | 27 South Cooks Bridge Rd, Suite M1, Jackson, NJ 08527 | 2014-09-25 |
| 1215341623 | Rite Aid | Pharmacy | 702 Bennett Mills Road, Jackson, NJ 08527 | 2014-06-13 |
| 1134251812 | Main Midtown Inc | Pharmacy | 346 E Fortification St, Jackson, MS 39202-2325 | 2007-03-09 |
| 1003943176 | Ljc,inc Dba Stone Drug | Pharmacy | 830 West Broadway, Box 9000, Jackson, WY 83001 | 2007-02-27 |
| 1003968322 | Carel Pharmacy | Pharmacy | 2010 W County Line Rd, Jackson, NJ 08527-2001 | 2007-01-17 |
| 1316095573 | Gold Kimball International, Inc. | Pharmacy | 2080 W County Line Rd, Jackson, NJ 08527-2015 | 2007-01-06 |
| Find all providers in JACKSON | ||||
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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.