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Contact Information

KROGER LIMITED PARTNERSHIP I
3265 SMOOT AVENUE
MADISON, WV25130
 Phone: 304-369-9074
 Fax: 304-369-9087
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
 

Durable Medical Equipment & Medical Supplies

332B00000X 54 Other Medical Supply Company
 

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for KROGER LIMITED PARTNERSHIP I

NPI # 1063446854
LBN Legal business name KROGER LIMITED PARTNERSHIP I
Authorized official ALLISON MUENNICH - (MANAGER OF PHARMACY LICENSING)
Entity Organization
Organization subpart 1 No
Enumeration date 07/10/2006
Last updated 09/15/2016 - About 10 years ago
Identifiers
WV License # 552286
OH Medicaid 3082613
WV Medicaid 0013178034
Other 2111327 PK
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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