Kroger Limited Partnership I

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

0201003731 Issued in VA

Legal business name

KROGER LIMITED PARTNERSHIP I

Doing business as

Kroger Apothecary Midatlantic

Practice address

621-F Township Plaza
Roanoke, VA 24014

Phone

(540) 345-6480

Fax

(540) 345-6844

NPI assigned

Dec 12, 2007

Last updated

Mar 7, 2023By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Jeff Thompson

Title

Pharmacy Merchandiser

Phone

(540) 563-3593

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• KROGER APOTHECARY MIDATLANTIC Doing business as

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• The Kroger Co

  dba Kroger Pharmacy

  • Community/Retail Pharmacy
  • Pickerington, OH
  • NPI 1245255967

  Member Of

  NPD member

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1197417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1063695187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 TOWNSIDE RD SW STE F",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240142297",
            "telephone_number": "540-345-6480",
            "fax_number": "540-345-6844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621-F TOWNSHIP PLAZA",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "24014",
            "telephone_number": "540-345-6480",
            "fax_number": "540-345-6844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KROGER LIMITED PARTNERSHIP I",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-12",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "PHARMACY MERCHANDISER",
        "authorized_official_telephone_number": "540-563-3593",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "VA",
            "license": "0201003731",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "VA",
            "license": "0201003731",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "4836055",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KROGER APOTHECARY MIDATLANTIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Asha Krishna, MD
• Sanjith Prahas Krishnam, MBBS
• Francene Lynne Kristoff
• Kroger Limited Partnership I (Kroger Pharmacy)
• Kroger Limited Partnership I (Kroger Pharmacy)
• Kroger Limited Partnership I (Kroger Pharmacy #401)
• Kroger Limited Partnership I (Kroger Pharmacy)
• Kroger Limited Partnership I (Kroger Pharmacy)
• Kroger Limited Partnership I (Kroger Pharmacy)
• Kroger Limited Partnership I (Kroger Pharmacy)

• Community/Retail Pharmacy in Roanoke, VA
• Providers in Roanoke, VA by specialty
• Community/Retail Pharmacy in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.