KROGER LIMITED PARTNERSHIP I (NPI# 1144393760) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144393760 |
| Entity Type | Organization |
| Organization Name | KROGER LIMITED PARTNERSHIP I |
| Other Organization Name | KROGER PHARMACY |
| Practice Address |
2321 N Wisconsin Ave Peoria IL 61603-5613 |
| Mailing Address |
Po Box 842772 Boston MA 02284-2772 |
| Practice Telephone | 3096889456 |
| Practice Fax Number | 3096889609 |
| Mailing Telephone | 5137621019 |
| Mailing Fax Number | 5137621092 |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2016-05-18 |
| Authorized Official Name | ALLISON MUENNICH (MANAGER OF PHARMACY LICENSING) |
| Authorized Official Telephone | 5137621019 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
054014396 | IL | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2025404 | 01 |
| Other Name | Type Code |
|---|---|
| KROGER PHARMACY | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649776477 | Kroger Limited Partnership I | Durable Medical Equipment & Medical Supplies | 1050 W Mercury Blvd, Hampton, VA 23666-3307 | 2018-04-02 |
| 1629574488 | Kroger Limited Partnership I | Durable Medical Equipment & Medical Supplies | 7254 Hayes Shopping Court, Hayes, VA 23072 | 2018-04-02 |
| 1215433271 | Kroger Limited Partnership I | Durable Medical Equipment & Medical Supplies | 1282 Smithfield Plz, Smithfield, VA 23430-6054 | 2018-03-30 |
| 1003312034 | Kroger Limited Partnership I | Durable Medical Equipment & Medical Supplies | 309 S Battlefield Blvd, Chesapeake, VA 23320 | 2018-03-30 |
| 1437655461 | Kroger Limited Partnership I | Durable Medical Equipment & Medical Supplies | 6500 George Washington Mem Hwy Ste C, Grafton, VA 23692 | 2018-03-30 |
| 1740780550 | Kroger Limited Partnership I | Durable Medical Equipment & Medical Supplies | 10679 N Michigan Rd, Zionsville, IN 46077-9261 | 2018-02-19 |
| 1700386521 | Kroger Limited Partnership I | Durable Medical Equipment & Medical Supplies | 715 S Tillotson Ave, Muncie, IN 47304-4526 | 2018-02-19 |
| 1649784174 | Kroger Limited Partnership I | Pharmacy | 5 Boone Vlg, Zionsville, IN 46077-1231 | 2017-11-20 |
| 1255845871 | Kroger Limited Partnership I | Durable Medical Equipment & Medical Supplies | 1500 W Mcgalliard Rd, Muncie, IN 47304-2203 | 2017-11-17 |
| 1649783432 | Kroger Limited Partnership I | Durable Medical Equipment & Medical Supplies | 227 W Michigan St, Indianapolis, IN 46204-1242 | 2017-11-15 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | Kroger Limited Partnership I | 1014 Vine Street, Cincinnati, Ohio 45202 |
| North Carolina Corporations | Kroger Limited Partnership I | 2626 Glenwood Avenue, Suite 550, Raleigh, NC 27608 |
| Indiana Business Entities | KROGER LIMITED PARTNERSHIP I | 1014 Vine St, Cincinnati, OH 45202 |
| Oklahoma Business Registrations | KROGER LIMITED PARTNERSHIP II | 1014 Vine St, Cincinnati, OH 45202 |
| Indiana Business Entities | KROGER LIMITED PARTNERSHIP II | 1014 Vine St, Cincinnati, OH 45202 |
| Street Address |
2321 N WISCONSIN AVE |
| City | PEORIA |
| State | IL |
| Zip Code | 61603-5613 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992757322 | Christine L Tharenos | Family Medicine | 2321 N Wisconsin Ave, Peoria, IL 61603-5613 | 2006-05-16 |
| 1083142038 | Samantha Elizabeth Martin | Advanced Practice Midwife | 2321 N Wisconsin Ave, Peoria, IL 61603-5613 | 2017-06-02 |
| 1740725837 | Angela Marie Miller | Nurse Practitioner | 2321 N Wisconsin Ave, Peoria, IL 61603-5613 | 2016-12-27 |
| 1235505108 | Bethany Joy Winfrey Ferguson | Nurse Practitioner | 2321 N Wisconsin Ave, Peoria, IL 61603-5613 | 2015-08-14 |
| 1932587797 | Elizabeth Gabel | Family Medicine | 2321 N Wisconsin Ave, Peoria, IL 61603-5613 | 2015-05-13 |
| 1588075048 | Mary Jennifer Sue Meister | Social Worker | 2321 N Wisconsin Ave, Peoria, IL 61603-5613 | 2014-05-17 |
| 1972932317 | Meghan Jean Khaiser | Physician Assistant | 2321 N Wisconsin Ave, Peoria, IL 61603-5613 | 2013-11-06 |
| 1811326317 | Carolyn Ann Calhoun | Advanced Practice Midwife | 2321 N Wisconsin Ave, Peoria, IL 61603-5613 | 2013-11-05 |
| 1467658443 | Heartland Community Health Clinic | Clinic/Center | 2321 N Wisconsin Ave, Peoria, IL 61603-5613 | 2007-06-26 |
| 1639215312 | Kwabena A Boateng | Obstetrics & Gynecology | 2321 N Wisconsin Ave, Peoria, IL 61603-5613 | 2007-01-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598362980 | Courtney Klein | Nurse Practitioner | 1306 N. Berkley Ave, Peoria, IL 61603 | 2020-10-08 |
| 1114588217 | Kong Xing Wang | Dentist | 320 East Armstrong Ave, Peoria, IL 61603 | 2019-06-28 |
| 1073015319 | Sara Kristine Rosenbery | Nurse Practitioner | 515 Ne Glen Oak Ave Ste 202, Peoria, IL 61603 | 2018-03-02 |
| 1861860058 | Jennifer Michelle Kelsey | Clinical Nurse Specialist | 420 Ne Glen Oak Avenue, Suite 401, Peoria, IL 61603 | 2015-09-04 |
| 1467859793 | Bonnie Lansing | Counselor | 617 N Gendale Avenue, Behavioral Health Adult Program, Peoria, IL 61603 | 2014-12-02 |
| 1639597172 | Jael K. Mahasi | Counselor | 1800 Ne Perry Avenue, Peoria, IL 61603 | 2014-04-02 |
| 1992054829 | Justin S Ferragut | Radiology | 530 Northeast Glen Oak Avenue, Peoria, IL 61603 | 2012-09-06 |
| 1780952994 | Syed Muhammad Tayyab | Internal Medicine | 828 Ne Glen Oak Ave Apt No208a, Peoria, IL 61603 | 2011-12-02 |
| 1528389079 | St. Francis Medical Center | General Acute Care Hospital | 530 N E Glen Oak Ave, Peoria, IL 61603 | 2010-06-18 |
| 1780810648 | Children's Home Association of Illinois | Voluntary or Charitable | 400 E. Frye, Peoria, IL 61603 | 2009-06-05 |
| Find all providers in zip 61603 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| 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. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831573021 | Hy Vee Inc | Pharmacy | 7610 N Orange Prairie Road, Peoria, IL 61615 | 2015-07-17 |
| 1184842718 | Harbor Vista | Pharmacy | 9133 W Thunderbird, #102, Peoria, AZ 85381 | 2007-04-20 |
| 1053415943 | German Dobson Cvs, L.L.C. | Pharmacy | 7530 W Cactus Rd, Peoria, AZ 85381-5202 | 2006-09-12 |
| 1750485645 | Cvs 3745 Peoria LLC | Pharmacy | 10727 W Olive Ave, Peoria, AZ 85345-9202 | 2006-09-12 |
| 1831293729 | German Dobson Cvs, L.L.C. | Pharmacy | 8332 W Thunderbird Rd, Peoria, AZ 85381-4822 | 2006-09-12 |
| 1093818866 | Highland Park Cvs, L.L.C. | Pharmacy | 3015 N Sterling Ave, Peoria, IL 61604-2259 | 2006-09-07 |
| 1114020880 | Highland Park Cvs, L.L.C. | Pharmacy | 9315 N Lindbergh Dr, Peoria, IL 61615-1454 | 2006-09-07 |
| 1053350439 | Albertsons LLC | Pharmacy | 7575 W Cactus Rd, Peoria, AZ 85381-5201 | 2006-06-04 |
| 1578513834 | Bogard Drug No. 5, Inc. | Pharmacy | 1102 S Western Ave, Peoria, IL 61605-3356 | 2006-05-10 |
| 1881000339 | Westgaterx Pharmacy | Pharmacy | 8914 N 91st Ave, S 100c, Peoria, AZ 85345-8396 | 2014-07-04 |
| Find all providers in PEORIA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.