MEDICARE: KENNIES MARKET INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy	PP415664L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2085038	OTHER		PK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083648067
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KENNIES MARKET INC

Provider Business Mailing Address
First Line	:	440 N MAIN ST
Second Line	:
City	:	SPRING GROVE
State	:	PA
Zip	:	17362-1122
Country	:	US
Telephone Number	:	717-225-9382
Fax Number	:	717-225-9362

Provider Business Practice Location Address
First Line	:	440 N MAIN ST
Second Line	:
City	:	SPRING GROVE
State	:	PA
Zip	:	17362-1122
Country	:	US
Telephone Number	:	717-225-9382
Fax Number	:	717-225-9362

Authorized Official
Title or Position	:	LEAD PHARMACIST/AO
Name	:	MARION LAMBERT
Credential	:	RPH
Telephone Number	:	717-359-4295

Provider Enumeration Date	:	07/10/2006
Last Update Date	:	07/19/2018

Similar Medicare Providers

1700367000 — HEATHER NICOLE DERENICK DPT
Practice Location Address:

488 N MAIN ST
SPRING GROVE, PA
17362-1122

Practice Phone: 717-690-0107
Practice Fax: 717-974-8743

1487859054 — AMY VILLARREAL
Practice Location Address:

1122 PORT ROYAL RD
PINGREE GROVE, IL
60140

Practice Phone: 224-639-5018
Practice Fax:

1437304912 — MR. FELIPE VILLARREAL JR.
Practice Location Address:

1122 PORT ROYAL RD
PINGREE GROVE, IL
60140

Practice Phone: 224-558-4971
Practice Fax: 847-453-7641

1003146796 — MR. JAVIER VILLARREAL
Practice Location Address:

1122 PORT ROYAL RD
PINGREE GROVE, IL
60140-9196

Practice Phone: 224-639-5017
Practice Fax:

1639619950 — JUMP FOR JOY THERAPY SERVICES INC
Practice Location Address:

1122 PORT ROYAL RD
PINGREE GROVE, IL
60140-9196

Practice Phone: 224-639-5018
Practice Fax: 888-759-8569

1992277792 — GOLDEN PATH SERVICES II, CORP
Practice Location Address:

1122 GROVE AVE
RACINE, WI
53405-3028

Practice Phone: 262-748-2596
Practice Fax:

Directions to “KENNIES MARKET INC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.