- Practice location
- 1550 E College Ave, Normal, IL 61761-2120
- Phone
- 309-452-0839
- Fax
- 309-454-2647
- Last updated
- April 22, 2025
Kroger Limited Partnership I is a healthcare organization based in Normal, IL. Kroger Limited Partnership I practices in Normal, IL. The NPI Number for Kroger Limited Partnership I is 1629141247 and holds a License No. 054011456 (IL). The current practice location address for Kroger Limited Partnership I is 1550 E College Ave, Normal, IL 61761-2120 and can be reached out via phone at 309-452-0839 and via fax at 309-454-2647.
Provider Profile Details
- NPI Number
- 1629141247
- Provider Name
- Kroger Limited Partnership I
- Provider Entity Type
- Organization
- Address
- 1550 E College Ave, Normal, IL 61761-2120
- Phone Number
- 309-452-0839
- Fax Number
- 309-454-2647
- Primary Taxonomy
- Pharmacy, Community/Retail Pharmacy · 3336C0003X
- Organization Subpart
- No
- Authorized Official
- Allison Muennich · Manager Of Pharmacy Licensing · 513-762-1019
- Other Names
- Kroger Pharmacy (Doing Business As)
- Provider Enumeration Date
- November 15, 2006
- Last Update Date
- April 22, 2025
- Certification Date
- April 22, 2025
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 1550 E College Ave
Normal, IL 61761-2120 - City
- Normal
- State
- Illinois
- Zip
- 61761-2120
- Phone Number
- 309-452-0839
- Fax Number
- 309-454-2647
Provider Business Mailing Address Details
- Address
- Po Box 842772
Boston, MA 02284-2772 - City
- Boston
- State
- MA
- Zip
- 02284-2772
- Phone Number
- 513-762-1019
- Fax Number
- 513-762-1092
License Information
- Taxonomy (1)
- Durable Medical Equipment & Medical Supplies · 332B00000X
- Taxonomy (2)
- Pharmacy · 333600000X
- License Number (3)
- 054011456
- License State (3)
- IL
- Taxonomy (3)
- Pharmacy, Community/Retail Pharmacy · 3336C0003X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
Other Pharmacy, Community/Retail Pharmacy providers near Normal, IL
View all Pharmacy, Community/Retail Pharmacy providers in Normal →Frequently Asked Questions
What is the NPI number of Kroger Limited Partnership I?
The NPI number of Kroger Limited Partnership I is 1629141247. It was assigned on November 15, 2006 and is currently active in the NPPES registry.
What is the specialty of Kroger Limited Partnership I?
Kroger Limited Partnership I is registered under the primary taxonomy Pharmacy, Community/Retail Pharmacy (code 3336C0003X), licensed in IL under license number 054011456.
Where does Kroger Limited Partnership I practice?
The practice location is 1550 E College Ave, Normal, IL 61761-2120. The office can be reached at 309-452-0839 (phone) or 309-454-2647 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1629141247 directly on the NPPES registry website.