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	333600000X	Pharmacy
2	332B00000X	Durable Medical Equipment & Medical Supplies
3	3336C0003X	Community/Retail Pharmacy	0201003627	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2104863	OTHER		PK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1508890377
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	:	2801 HICKS RD
Second Line	:
City	:	NORTH CHESTERFIELD
State	:	VA
Zip	:	23235-6337
Country	:	US
Telephone Number	:	804-675-4519
Fax Number	:	804-675-4528

Authorized Official
Title or Position	:	MANAGER OF PHARMACY LICENSING
Name	:	ALLISON MUENNICH
Credential	:
Telephone Number	:	513-762-1019

Provider Enumeration Date	:	07/10/2006
Last Update Date	:	05/16/2016

Similar Medicare Providers

1316322357 — JESSICA MCDANIEL PHARM.D.
Practice Location Address:

2801 HICKS RD
NORTH CHESTERFIELD, VA
23235-6337

Practice Phone: 804-675-4519
Practice Fax:

1194027979 — JESSICA NICOLE FARMER PHARMD
Practice Location Address:

2801 HICKS RD , KROGER PHARMACY
RICHMOND, VA
23235-6337

Practice Phone: 804-675-4519
Practice Fax: 804-675-4528

1275839409 — BRANDON PAUL EVANS PHARM. D.
Practice Location Address:

2801 HICKS RD
RICHMOND, VA
23235-6337

Practice Phone: 804-675-4519
Practice Fax:

1447735774 — CHRISTINE A JACKSON
Practice Location Address:

2791 BURRI TER
NORTH PORT, FL
34288-6337

Practice Phone: 941-445-3021
Practice Fax:

1205390937 — MR. & MRS. TRANSPORT, LLC
Practice Location Address:

2791 BURRI TER
NORTH PORT, FL
34288-6337

Practice Phone: 321-243-9181
Practice Fax:

1104636711 — STATEN CLINIC
Practice Location Address:

6516 NEW RD
NORTH ZULCH, TX
77872-6337

Practice Phone: 281-740-2405
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 © 2007-2025 (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.