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Kroger Limited Partnership I
Community/Retail Pharmacy in Mount Vernon, Illinois
NPI 1316971120

Kroger Limited Partnership I is a Community/Retail Pharmacy based in Boston, IL and is specialized in Community/Retail Pharmacy. Kroger Limited Partnership I practices in Mount Vernon, IL. The NPI Number for Kroger Limited Partnership I is 1316971120 and holds a License No. (Illinois).

The current practice location address for Kroger Limited Partnership I is 415 S 42Nd St, Mount Vernon, IL and can be reached out via phone at 618-244-9660 and via fax at 618-244-9551.

Location: 415 S 42Nd St, Mount Vernon, IL, 02284-2772
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1316971120
Provider Name
Kroger Limited Partnership I
Credential
Provider Entity Type
Organization
Address
415 S 42Nd St, Mount Vernon, IL, 02284-2772
Phone Number
618-244-9660
Fax Number
618-244-9551
Provider Enumeration Date
07/10/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
2023723 01 PK
institution
Provider Business Practice Location Address Details
Address
415 S 42Nd St
City
Mount Vernon
State
Illinois
Zip
62864-6266
Phone Number
618-244-9660
Fax Number
618-244-9551
person
Provider Business Mailing Address Details
Address
415 S 42Nd St
City
Mount Vernon
State
Illinois
Zip
62864-6266
Phone Number
618-244-9660
Fax Number
618-244-9551
person
Provider's Taxonomy Details 1
Type
Suppliers
Classification
Durable Medical Equipment & Medical Supplies
Speciality
-
Taxonomy
332B00000X
License No.
54013385 (Illinois)
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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