MEDICARE: KROGER LIMITED PARTNERSHIP I

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	332B00000X	Durable Medical Equipment & Medical Supplies
2	333600000X	Pharmacy
3	3336C0003X	Community/Retail Pharmacy	021043700	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2070869	OTHER		PK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1407880206
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KROGER LIMITED PARTNERSHIP I

Provider Business Mailing Address
First Line	:	PO BOX 842772
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02284-2772
Country	:	US
Telephone Number	:	513-762-1019
Fax Number	:	513-762-1092

Provider Business Practice Location Address
First Line	:	1474 MAIN ST
Second Line	:
City	:	HAMILTON
State	:	OH
Zip	:	45013-1074
Country	:	US
Telephone Number	:	513-868-6578
Fax Number	:	513-868-8056

Authorized Official
Title or Position	:	MANAGER PHARMACY LICENSING
Name	:	JESSIE WARMAN
Credential	:
Telephone Number	:	513-762-1090

Provider Enumeration Date	:	07/10/2006
Last Update Date	:	02/04/2020

Similar Medicare Providers

1437547023 — CARLISA E WALDMAN FNP-C
Practice Location Address:

1474 MAIN ST
HAMILTON, OH
45013-1074

Practice Phone: 513-896-8967
Practice Fax:

1821480120 — JENNIFER HEEG PHARMD
Practice Location Address:

1474 HAMILTON RICHMOND RD
HAMILTON, OH
45013-1074

Practice Phone: 513-868-6578
Practice Fax:

1942692314 — DR. ZACKERY ROMER PHARM D.
Practice Location Address:

1474 HAMILTON RICHMOND RD
HAMILTON, OH
45013-1074

Practice Phone: 513-868-6578
Practice Fax: 513-868-8056

1215329503 — KWASI AMFO-ANTIRI
Practice Location Address:

1474 HAMILTON RICHMOND RD
HAMILTON, OH
45013-1074

Practice Phone: 513-868-6578
Practice Fax: 513-868-8056

1154781656 — MELISSA LYNN TRABEL
Practice Location Address:

1474 MAIN ST
HAMILTON, OH
45013-1074

Practice Phone: 513-896-8967
Practice Fax:

1669007399 — CANDICE DAVIS NP-C
Practice Location Address:

1474 MAIN ST
HAMILTON, OH
45013-1074

Practice Phone: 513-896-8967
Practice Fax:

Directions to “KROGER LIMITED PARTNERSHIP I ” 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.