# KROGER LIMITED PARTNERSHIP I

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- **Entity:** Organization
- **Status:** Active
- **Other names:** KROGER PHARMACY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1386678167
- **Authorized official:** JESSIE WARMAN (MANAGER OF PHARMACY)
- **Authorized official phone:** (513) 762-1090

## Contact information

- **Practice address:** 3095 GOODMAN RD E, SOUTHAVEN, MS 38672-8707
- **Practice address phone:** (662) 536-3743
- **Practice address fax:** (662) 536-3746
- **Mailing address:** PO BOX 842772, BOSTON, MA 02284-2772
- **Mailing address phone:** (513) 762-1019
- **Mailing address fax:** (513) 762-1092

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 6159 | MS | Yes |

## Other

- **Enumeration date:** 07/10/2006
- **Last updated:** 04/22/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 09535053 | — | MS |
| 01 | — | 2046758 | PK | — |