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	60005153	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2027695	OTHER		PK

General Provider Information

NPI Number	:	1740353267
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	:	209 CHICAGO AVE
Second Line	:
City	:	GOSHEN
State	:	IN
Zip	:	46526-2311
Country	:	US
Telephone Number	:	574-534-9223
Fax Number	:	574-533-0804

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

Provider Enumeration Date	:	11/15/2006
Last Update Date	:	05/16/2016

Similar Medicare Providers

1780220277 — STACIA STULTS
Practice Location Address:

209 CHICAGO AVE
GOSHEN, IN
46526-2311

Practice Phone: 574-534-9223
Practice Fax:

1518506484 — SCOTT LUNG RPH
Practice Location Address:

209 CHICAGO AVE
GOSHEN, IN
46526-2311

Practice Phone: 574-534-9223
Practice Fax: 574-533-0804

1245843176 — DR. MICHAEL BESSESEN PHARMD
Practice Location Address:

209 CHICAGO AVE
GOSHEN, IN
46526-2311

Practice Phone: 574-534-9223
Practice Fax:

1487327458 — KRISTEN NICOLE ALCANTARA PTA
Practice Location Address:

223 CHICAGO AVE
GOSHEN, IN
46526-2311

Practice Phone: 574-584-3200
Practice Fax: 574-584-3204

1003775198 — JOHNATHON THOMAS CLIFTON
Practice Location Address:

200 HIGH PARK AVE
GOSHEN, IN
46526-4810

Practice Phone: 312-599-7043
Practice Fax:

1063705192 — DR. MEGAN LEE BROWN DC
Practice Location Address:

1824 W LINCOLN AVE
GOSHEN, IN
46526-5918

Practice Phone: 574-534-6824
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.