Kroger Limited Partnership I
NPI 1164670063 · Community/Retail Pharmacy · Vicksburg, MS
Enrolled with Medicare as Dme Supplier - Pharmacy · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Kroger Limited Partnership I is a Community/Retail Pharmacy organization in Vicksburg, MS (NPI 1164670063).
Provider details
- NPI number
- 1164670063
- Entity type
- Organization
- Primary specialty
- Community/Retail PharmacySuppliers
- Organization subpart
- No
- Authorized official
- Jessie Warman, Manager of Pharmacy Licensing(513) 762-1090
Specialties & taxonomies
Suppliers
Suppliers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure28% of score
17 yrs in NPPES registry
- Profile completeness28% of score
100% of core fields populated
- Practice footprint17% of score
1 documented practice location
- Medicare service volume (vs. specialty peers)28% of score
535 Medicare services, 2024 (ranked within specialty)
Medicare volume is ranked against active providers in the same specialty. Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
What this provider does (Medicare)
Based on Medicare fee-for-service claims, 2024; not all care is captured.
| Service (HCPCS) | Medicare services | Typical Medicare-allowed (2024) |
|---|---|---|
| Admn Sarscov2 Vacc 1 Dose90480 | 258 | $30 |
| Administration of Influenza Virus VaccineG0008 | 245 | $12 |
| Administration of Pneumococcal VaccineG0009 | 32 | $18 |
Typical Medicare-allowed amounts for these services range $12–$30 (2024). The Medicare-allowed amount is what Medicare recognizes for a service under fee-for-service — a reference figure for 2024, not a price quote and not what you would be billed. Medicare Part B covers roughly an eighth of all NPIs (65+ skew); services with fewer than 11 beneficiaries are suppressed by CMS. Source: CMS Medicare Physician & Other Practitioners, by Provider & Service.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Kroger Pharmacy
- Doing business as
- Kroger Pharmacy
Registry dates
- Enumerated
- 2008-09-04
- Last updated
- 2020-03-13
- Certified
- 2020-03-13
Frequently asked questions
- What is Kroger Limited Partnership I's NPI number?
- Kroger Limited Partnership I's National Provider Identifier (NPI) is 1164670063, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Kroger Limited Partnership I?
- Kroger Limited Partnership I is classified in the NPPES registry as Community/Retail Pharmacy (Suppliers).
- Where is Kroger Limited Partnership I located?
- Kroger Limited Partnership I's practice location on file with NPPES is 3408 Pemberton Square Blvd, Vicksburg, MS 39180-5573.
- What is Kroger Limited Partnership I's phone number?
- The practice phone number listed in the NPPES registry for Kroger Limited Partnership I is (601) 630-4003.
- Does Kroger Limited Partnership I accept Medicare?
- Kroger Limited Partnership I is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Kroger Limited Partnership I?
- The authorized official listed on Kroger Limited Partnership I's NPPES record is Jessie Warman, Manager of Pharmacy Licensing. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Kroger Limited Partnership I's NPI active?
- Yes — Kroger Limited Partnership I's NPI (1164670063) is active in the NPPES registry as of the last update on 2020-03-13.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.