Kroger Pharmacy #25-457

LBN: Kroger Limited Partnership I
Kroger Pharmacy #25-457 is an health care organization with primary practice located at 1230 N Houston Levee Rd , Cordova TN 38018-6653. 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 (901) 751-0394, or through Warman, Jessie via phone (513) 762-1090.

Contact Information

Primary practice address
1230 N Houston Levee Rd Cordova TN 38018-6653
Fax: (901) 751-4213
Website:
Authorized official contact:
Name: Warman, Jessie

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X 3794 Tennessee

Profile Details

NPI number 1902821622
LBN Legal business name Kroger Limited Partnership I
DBA Doing business as Kroger Pharmacy #25-457
Authorized official Warman, Jessie
Entity Organization
Organization subpart 1 No
Enumeration date Jul 13th, 2006
Last updated Mar 13th, 2020 - about 4 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 1902821622 NPPES
Tennessee MEDICAID 4435865
Tennessee Other 2093262

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