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KROGER LIMITED PARTNERSHIP I
NPI 1629464524
Pharmacy - Community/Retail Pharmacy in Kendallville, IN

Active since April 08, 2015
310 W NORTH ST, KENDALLVILLE, IN 46755(260) 347-9177(260) 347-9125 Get Directions Write a Review

NPPES record last updated: April 22, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Nov 19, 2018, May 16, 2016, Feb 15, 2016 and 1 more (4 updates tracked since 2016).

About Kroger Limited Partnership I NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KROGER LIMITED PARTNERSHIP I (NPI 1629464524), doing business as Kroger Pharmacy #418, is a healthcare organization registered as a community/retail pharmacy in Kendallville, Indiana and active in the NPI registry since April 2015. The organization lists Jessie Warman, Manager Rx Licensing, as its authorized official.

NPPES Registry Identity

NPI1629464524
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameKROGER LIMITED PARTNERSHIP I
Location Address310 W NORTH STKendallville, IN 46755-1004
Mailing AddressPo Box 842772Boston, MA 02284-2772 · (513) 762-1019 · Fax (513) 762-1092
Phone(260) 347-9177
Fax(260) 347-9125
Organization SubpartNo
Authorized OfficialJessie WarmanManager Rx Licensing · (513) 762-1019
Enumeration DateApril 8, 2015
Last NPPES UpdateApril 22, 20254 updates tracked since enumeration
NPPES CertifiedApril 22, 2025
✔ NPI 1629464524 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
License✔ Licensed in IN · 60006490A
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.

Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X
310 W NORTH ST, Kendallville, IN 46755
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Other Names 1

Doing Business AsKroger Pharmacy #418

Other Identifiers 2

Medicaid201328840AIN
Other2151268Pk

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arizona Complete Health and more.Insurance ›

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
104 services104 patients
Influenza vaccine split virus, preservative free 90662
The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.
101 services101 patients
Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677
The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.
27 services27 patients
Administration of pneumococcal vaccine G0009
The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.
27 services27 patients

Medical Equipment Supplier Medicare DMEPOS 14

Medicare supplier enrollment and the product categories Kroger Pharmacy #418 carries, from the Medicare DMEPOS supplier directory.

Kroger Pharmacy #418

DMEPOS supplier · Kendallville, INOperated by Kroger Limited Partnership I
✔

Accepts Medicare assignment

Kroger Pharmacy #418 agrees to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients are not billed beyond the standard deductible and coinsurance.

PTAN (Medicare Supplier Number)20597219
Medicare Participant SinceAugust 27, 2003
Supplier Location310 W North StKendallville, IN 46755
Phone(260) 347-9177
Supplier Specialties
Pharmacy

Medicare Product Categories

Immunosuppressive Drugs
Immunosuppressive drugs require dosage, frequency, and route of administration to prevent or treat the rejection of an organ transplant
Nebulizer Drugs
Albuterol, levalbuterol, and metaproterenol are all short-acting bronchodilators with beta-adrenergic stimulatory effect
Oral Anticancer Drugs
FDA anticancer drugs
Oral Antiemetic Drugs
FDA antiemetic drugs
Commodes, Urinals, Bedpans
Raised toilets, Drop-arm commodes, Folding commodes, Plastic urinals, Plastic bedpans, Disposable urinals
Blood Glucose Monitors/Supplies (Non-Mail Order)
Home blood glucose monitors including lancets, reagent strips, and other supplies necessary for the proper functioning of the device
Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MEGAN A DYER PHARMD
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
310 W NORTH ST
KENDALLVILLE, IN 46755
Noble County (260) 347-9177
JESSICA SUZANNE KOMOSINSKI PHARMD
Pharmacist
310 W NORTH ST
KENDALLVILLE, IN 46755
Noble County (260) 347-9177
MATTHEW GROSSMAN
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
310 W NORTH ST
KENDALLVILLE, IN 46755
Noble County (260) 347-9177
LOUISA VISOCKY RPH
Pharmacist
310 W NORTH ST
KENDALLVILLE, IN 46755
Noble County (260) 347-9177

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kroger Limited Partnership I's NPI number?

The NPI number for Kroger Limited Partnership I is 1629464524. It was assigned to this organization in the NPPES registry on April 8, 2015. The provider is doing business as Kroger Pharmacy #418.

Where is Kroger Limited Partnership I located?

Kroger Limited Partnership I is located at 310 W North St, Kendallville, IN 46755. The listed phone number is (260) 347-9177.

What is Kroger Limited Partnership I's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

Does Kroger Limited Partnership I accept Medicare assignment for medical equipment?

Yes. As a Medicare medical equipment supplier, Kroger Pharmacy #418 accepts Medicare assignment: the supplier accepts the Medicare-approved amount as payment in full for covered equipment and supplies.

What insurance does Kroger Limited Partnership I accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter from Absolute Total Care, Ambetter from Arizona Complete Health and Ambetter from Arkansas Health & Wellness and 45 other insurers list Kroger Limited Partnership I as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kroger Limited Partnership I was last updated on April 22, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.