Scotts Pharmacy J 404

LBN: Kroger Limited Partnership I
Scotts Pharmacy J 404 is an health care organization with primary practice located at 5300 Decatur Rd , Fort Wayne IN 46806-3058. The organization recently has only one registered license in Suppliers / Community/Retail Pharmacy, which is considered as the primary health care specialty. Kroger Limited Partnership I can be contacted via phone (260) 458-0840, or through Mineer, Matt via phone (513) 387-7074.

Contact Information

Primary practice address
5300 Decatur Rd Fort Wayne IN 46806-3058
Phone: (260) 458-0840
Fax: (260) 458-9302
Website:
Map and Directions
Authorized official contact:
Name: Mineer, Matt CPHT
Phone: (513) 387-7074

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Community/Retail Pharmacy 3336C0003X 60006086A Indiana

Profile Details

NPI number 1659576395
LBN Legal business name Kroger Limited Partnership I
DBA Doing business as Scotts Pharmacy J 404
Authorized official Mineer, Matt CPHT
Entity Organization
Organization subpart 1 No
Enumeration date Jun 20th, 2007
Last updated Jun 24th, 2009 - about 15 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1659576395 NPPES
Other 1561542 NCPDP PROVIDER IDENTIFICATION NUMBER
MEDICAID 200872420A NCPDP PROVIDER IDENTIFICATION NUMBER

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