Active NPI
Meijer, Inc.
Doing business as Meijer Pharmacy #278
- Community/Retail Pharmacy
- Flat Rock, MI
National Provider Identifier
1033573605
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- Legal business name
- MEIJER, INC.
- Doing business as
- Meijer Pharmacy #278
- Practice address
- 26100 Vreeland Rd
Flat Rock, MI 48134-1692 - Phone
- (734) 984-1110
- Fax
- (734) 984-1065
- NPI assigned
- Apr 11, 2016
- Last updated
- Oct 20, 2016
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jason Beauch, R.PH
- Title
- VP of Pharmacy Merchandising
- Phone
- (616) 791-3169
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | NU | ||
| Community/Retail Pharmacy | 3336C0003X | NU | Primary |
Addresses
Primary practice location
26100 Vreeland Rd
Flat Rock, MI 48134-1692
Mailing address
2929 Walker Ave NW
Grand Rapids, MI 49544-6402
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033573605 | Medicaid | MI |
Other names 1
- Meijer Pharmacy #278
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20071022000424 | MI | Part B Supplier - Mass Immunization (Roster Biller Only) | 8325015639 | This NPI is an additional NPI on the enrollment |
| O20160816001169 | MI | DME Supplier - Pharmacy | 8325015639 | Practice locations: Flat Rock, MI |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 23D2114496 | Meijer Pharmacy #278 | Certificate of waiver | Jun 14, 2028 |
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Meijer Pharmacy #278 | Epoetin|Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order)|Canes and/or Crutches|Walkers | Does not accept assignment |
National Provider Directory
National Provider Directory- Tax ID family
- Meijer Pharmacy 337
Organizations with this tax ID in the same state 14
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Pharmacist
- Grand Rapids, MI
- NPI 1518380062
-
- Pharmacy Technician
- Flat Rock, MI
- NPI 1063093052
-
- Pharmacist
- Reno, NV
- NPI 1982110193
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1460332800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1476921600000",
"number": "1033573605",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2929 WALKER AVE NW",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495446402"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "26100 VREELAND RD",
"city": "FLAT ROCK",
"state": "MI",
"postal_code": "481341692",
"telephone_number": "734-984-1110",
"fax_number": "734-984-1065"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MEIJER, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2016-04-11",
"last_updated": "2016-10-20",
"status": "A",
"authorized_official_last_name": "BEAUCH",
"authorized_official_first_name": "JASON",
"authorized_official_title_or_position": "VP OF PHARMACY MERCHANDISING",
"authorized_official_telephone_number": "616-791-3169",
"authorized_official_credential": "R.PH"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1033573605",
"state": "MI"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Meijer Pharmacy #278",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Flat Rock, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.