NPIMap

Organization Active NPI

Kroger Limited Partnership I

  • Community/Retail Pharmacy
  • Danville, VA
National Provider Identifier
1891729661
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
KROGER LIMITED PARTNERSHIP I
Practice address
143 Crown Dr
Danville, VA 24540-5933
Phone
(434) 792-6039
Fax
(434) 792-5596
NPI assigned
Jul 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Tracy Ward
Title
Pharmacy Merchandiser
Phone
(540) 563-3593

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 0201003390 VA
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

143 Crown Dr
Danville, VA 24540-5933

Mailing address

143 Crown Dr
Danville, VA 24540-5933

Other identifiers 1

IdentifierTypeStateIssuer
4830508OtherOTHER ID NUMBER-COMMERCIAL NUMBER

Other names 1

  • KROGER PHARMACY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040721001195 WV Part B Supplier - Mass Immunization (Roster Biller Only) 8224930136 This NPI is an additional NPI on the enrollment
Practice locations: Logan, WV; Parkersburg, WV; Madison, WV; Marmet, WV; Morgantown, WV; Oak Hill, WV; Princeton, WV; Rainelle, WV…

National Provider Directory

National Provider Directory
Tax ID family
Krogerthe Kroger Pharmac611 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 17

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 17

Locations

143 Crown Dr
Danville, VA 24540
Phone (434) 792-6039

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1891729661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "143 CROWN DR",
            "city": "DANVILLE",
            "state": "VA",
            "postal_code": "245405933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "143 CROWN DR",
            "city": "DANVILLE",
            "state": "VA",
            "postal_code": "245405933",
            "telephone_number": "434-792-6039",
            "fax_number": "434-792-5596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KROGER LIMITED PARTNERSHIP I",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-10",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "WARD",
        "authorized_official_first_name": "TRACY",
        "authorized_official_title_or_position": "PHARMACY MERCHANDISER",
        "authorized_official_telephone_number": "540-563-3593"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "VA",
            "license": "0201003390",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "4830508",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KROGER PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Danville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.