Organization · Type 2 NPI

Kroger Limited Partnership I

Community/Retail Pharmacy · Cordova, TN

NPI number 1902821622 Active

Practice location

1230 N Houston Levee Rd
Cordova, TN 38018-6653

Call (901) 751-0394 Map

Fax (901) 751-1067

Mailing address

PO Box 842772
Boston, MA 02284-2772

Specialties and licenses

Taxonomy	Code	License
Durable Medical Equipment & Medical Supplies	332B00000X	None listed
Pharmacy	333600000X	None listed
Community/Retail Pharmacy Primary	3336C0003X	3794 (TN)

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 …

4 other providers at this address

Other community/retail pharmacy providers in Cordova

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NPI record

NPI: 1902821622
Entity type: Organization (Type 2)
Issued: Jul 13, 2006
Last updated: Apr 22, 2025
Status: Active

Other names

<unavail>
Kroger Pharmacy #25-457 · doing business as
Kroger Pharmacy #25-457 · doing business as

Authorized official

Jessie Warman
Manager of Pharmacy Licensing
(513) 762-1090

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1902821622

Kroger Limited Partnership I's National Provider Identifier is 1902821622, issued on Jul 13, 2006. The primary taxonomy on file is Community/Retail Pharmacy (3336C0003X), and the practice location is in Cordova, TN. The record was last updated on Apr 22, 2025.