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Kroger Limited Partnership I
Community/Retail Pharmacy in Vicksburg, Mississippi
NPI 1093749871

Kroger Limited Partnership I is a Community/Retail Pharmacy based in Memphis, MS and is specialized in Community/Retail Pharmacy. Kroger Limited Partnership I practices in Vicksburg, MS. The NPI Number for Kroger Limited Partnership I is 1093749871 and holds a License No. (Mississippi).

The current practice location address for Kroger Limited Partnership I is 3405 Pemberton Square Blvd, Vicksburg, MS and can be reached out via phone at 601-638-3412 and via fax at 601-638-3628.

Location: 3405 Pemberton Square Blvd, Vicksburg, MS, 38120-9427
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1093749871
Provider Name
Kroger Limited Partnership I
Credential
Provider Entity Type
Organization
Address
3405 Pemberton Square Blvd, Vicksburg, MS, 38120-9427
Phone Number
601-638-3412
Fax Number
601-638-3628
Provider Enumeration Date
07/10/2006
Last Update Date
03/12/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
0330556 05 MS
2514873 01 NCPDP PROVIDER IDENTIFICATION NUMBER
institution
Provider Business Practice Location Address Details
Address
3405 Pemberton Square Blvd
City
Vicksburg
State
Mississippi
Zip
39180-5574
Phone Number
601-638-3412
Fax Number
601-638-3628
person
Provider Business Mailing Address Details
Address
3405 Pemberton Square Blvd
City
Vicksburg
State
Mississippi
Zip
39180-5574
Phone Number
601-638-3412
Fax Number
601-638-3628
person
Provider's Taxonomy Details 1
Type
Suppliers
Classification
Durable Medical Equipment & Medical Supplies
Speciality
-
Taxonomy
332B00000X
License No.
1957012 (Mississippi)
Definition
A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.
person
Provider's Taxonomy Details 2
Type
Suppliers
Classification
Pharmacy
Speciality
-
Taxonomy
333600000X
License No.
()
Definition
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.
person
Provider's Taxonomy Details 3
Type
Suppliers
Classification
Pharmacy
Speciality
Community/Retail Pharmacy
Taxonomy
3336C0003X
License No.
()
Definition
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.
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