Kroger Pharmacy
LBN: Kroger Limited Partnership I
Kroger Pharmacy is an health care organization with primary practice located at 3405 Pemberton Square Blvd , Vicksburg MS 39180-5574. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty.
Kroger Limited Partnership I can be contacted via phone (601) 638-3412, or through Mineer, Matt via phone (513) 387-7074.
Contact Information
Primary practice address
3405 Pemberton Square Blvd
Vicksburg MS 39180-5574
Phone: (601) 638-3412
Fax: (601) 638-3628
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Durable Medical Equipment & Medical Supplies | 332B00000X | ||
| Suppliers / Pharmacy | 333600000X | ||
| Suppliers / Community/Retail Pharmacy | 3336C0003X | 1957012 | Mississippi |
Profile Details
| NPI number | 1093749871 |
|---|---|
| LBN Legal business name | Kroger Limited Partnership I |
| DBA Doing business as | Kroger Pharmacy |
| Authorized official | Mineer, Matt |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jul 10th, 2006 |
| Last updated | Jun 24th, 2009 - about 17 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1093749871 | NPPES |
| Mississippi | MEDICAID | 0330556 | |
| Mississippi | Other | 2514873 |
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