Kroger Limited Partnership I
Organization Active NPI Community/Retail Pharmacy · Hendersonville, TN
NPI 1760416499 · NPPES record last updated May 16, 2016
Key facts
- NPI
- 1760416499
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- 1495 (TN)
- Legal business name
- KROGER LIMITED PARTNERSHIP I
- Practice address
- 170 E Main St
Hendersonville, TN 37075-2587 - Phone
- (615) 822-6797
- Fax
- (615) 822-0962
- NPI assigned
- Jul 10, 2006
- Organization subpart
- No
Authorized official
- Name
- Allison Muennich
- Title
- Manager of Pharmacy Licensing
- Phone
- (513) 762-1019
Corporate family (same tax ID) 24
Member of 1
Practitioners 3
-
Vivian Paige Barham, RPH
-
Walter Bryant Reed, RPH
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in TN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080114000140 | TN | Part B Supplier - Mass Immunization (Roster Biller Only) | 8224930136 | This NPI is an additional NPI on the enrollment |
| O20100930047636 | TN | DME Supplier - Pharmacy | 8224930136 | Practice locations: Hendersonville, TN |
National Provider Directory
- Tax ID family
- Krogerthe Kroger Pharmac
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | 1495 | TN | Yes |
Addresses
Primary practice location
170 E Main St
Hendersonville, TN 37075-2587
Mailing address
PO Box 842772
Boston, MA 02284-2772
Phone (513) 762-1019
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2089474 | Other | PK |
Other names
- KROGER PHARMACY
Other providers in Hendersonville, TN
- Jeremy Kozuh
- Ashley Lynne Krape
- Robert J Krauth
- Jordyn Kriegl
- Kroger Limited Partnership I
- Caili Krohn
- Peter B Kroll
- Brynn Krutmeier
- Paul Edward Kudelko II
- Sabrina Ann La Croix
All providers in Hendersonville, TN · Community/Retail Pharmacy in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 16, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.