1. Home
  2. Directory
  3. Mississippi
  4. Clinton
  5. Pharmacy
  6. NPI Profile

KROGER PHARMACY
NPI 1639103401
Pharmacy - Community/Retail Pharmacy in Clinton, MS

Active since July 10, 2006
406 SPRINGRIDGE RD, CLINTON, MS 39056(601) 924-7422(601) 924-7423 Get Directions Write a Review

NPPES record last updated: June 24, 2009. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Kroger Pharmacy NPPES

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

KROGER PHARMACY (NPI 1639103401) is a healthcare organization registered as a community/retail pharmacy in Clinton, Mississippi and active in the NPI registry since July 2006. The organization lists Matt Mineer, Interface Manager, as its authorized official.

NPPES Registry Identity

NPI1639103401
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameKROGER LIMITED PARTNERSHIP I
Location Address406 SPRINGRIDGE RDClinton, MS 39056-4804
Mailing Address800 Ridge Lake BlvdMemphis, TN 38120-9427 · (901) 765-4157 · Fax (901) 765-4213
Phone(601) 924-7422
Fax(601) 924-7423
Organization SubpartNo
Authorized OfficialMatt MineerInterface Manager · (513) 387-7074
Enumeration DateJuly 10, 2006
Last NPPES UpdateJune 24, 2009
✔ NPI 1639103401 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
License✔ Licensed in MS · 1559012
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
Also ListedPharmacyTaxonomy 333600000X
406 SPRINGRIDGE RD, Clinton, MS 39056
Open in Google Maps ↗

Other Names 1

Doing Business AsKroger Pharmacy

Other Identifiers 4

Medicare PIN730000003
Other2512502Ncpdp Provider Identification Number
Medicaid0330553MS
Medicare NSC1193770154

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 1639103401. It was assigned to this organization in the NPPES registry on July 10, 2006. The provider is doing business as Kroger Pharmacy.

Where is Kroger Limited Partnership I located?

Kroger Limited Partnership I is located at 406 Springridge Rd, Clinton, MS 39056. The listed phone number is (601) 924-7422.

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.

When was this NPI record last updated?

The NPPES record for Kroger Limited Partnership I was last updated on June 24, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.