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Meijer Inc

Organization Active NPI Community/Retail Pharmacy · Saginaw, MI

NPI 1144360694 · NPPES record last updated Mar 17, 2014

Key facts

NPI
1144360694
Entity type
Organization (NPI type 2)
Primary specialty
Community/Retail Pharmacy 3336C0003X
License
5301003600 (MI)
Legal business name
MEIJER INC
Practice address
3360 Tittabawassee Rd
Saginaw, MI 48604-9453
Phone
(989) 249-6010
Fax
(989) 249-6065
NPI assigned
Feb 7, 2007
Organization subpart
No

Authorized official

Name
Jason Beauch, RPH
Title
Director of Pharmacy Managed Care
Phone
(616) 791-3169

Corporate family (same tax ID) 24

Organizations that report the same tax identification number in the National Provider Directory.

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Meijer Pharmacy #043
3360 Tittabawassee Rd, Saginaw, MI 48604-9453 · (989) 249-6010		 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order)|Canes and/or Crutches|Walkers|Surgical Dressings Does not accept assignment
Participating since Jan 1, 1998

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in MI

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20071022000424 MI Part B Supplier - Mass Immunization (Roster Biller Only) 8325015639 This NPI is an additional NPI on the enrollment
O20100930089314 MI DME Supplier - Pharmacy
DME Supplier - Grocery Store
DME Supplier - Department Store		 8325015639 Practice locations: Saginaw, MI

National Provider Directory

Tax ID family
Meijer (127 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 5301003600 MI
Community/Retail Pharmacy 3336C0003X 5301003600 MI Yes

Addresses

Primary practice location

3360 Tittabawassee Rd
Saginaw, MI 48604-9453

Mailing address

2929 Walker Ave NW
Grand Rapids, MI 49544-9424
Phone (616) 791-3169

Other identifiers

IdentifierTypeStateIssuer
2329856MedicaidMI

Other names

  • Meijer Pharmacy #043 Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 17, 2014.

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395014400000",
    "number": "1144360694",
    "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": "495449424",
            "telephone_number": "616-791-3169",
            "fax_number": "616-735-8532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3360 TITTABAWASSEE RD",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486049453",
            "telephone_number": "989-249-6010",
            "fax_number": "989-249-6065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEIJER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-07",
        "last_updated": "2014-03-17",
        "status": "A",
        "authorized_official_last_name": "BEAUCH",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "DIRECTOR OF PHARMACY MANAGED CARE",
        "authorized_official_telephone_number": "616-791-3169",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MI",
            "license": "5301003600",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301003600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2329856",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Meijer Pharmacy #043",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saginaw, MI

All providers in Saginaw, MI · Community/Retail Pharmacy in Michigan

Sources for this page

Verify at the official NPI Registry.