Meijer Stores Limited Partnership

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

02-687900 Issued in OH

Legal business name

MEIJER STORES LIMITED PARTNERSHIP

Doing business as

Meijer Pharmacy #104

Practice address

1661 Hilliard Rome Rd
Columbus, OH 43228-9485

Phone

(614) 529-5110

Fax

(614) 529-5165

NPI assigned

Oct 9, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jason Beauch, RPH

Title

Director of Pharmacy Managed Care

Phone

(616) 791-3169

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Meijer Pharmacy #104 Doing business as

Medicare fee-for-service enrollment

Enrolled in OH2 enrollments

Enrollment records 2

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

CLIA laboratory certificates

Medicare medical equipment & supply locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395014400000",
    "number": "1295822443",
    "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": "1661 HILLIARD ROME RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432289485",
            "telephone_number": "614-529-5110",
            "fax_number": "614-529-5165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEIJER STORES LIMITED PARTNERSHIP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-09",
        "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": "OH",
            "license": "02687900",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OH",
            "license": "02-687900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0856926",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Meijer Pharmacy #104",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nickolas John Meier, DO
• Shane Meier
• Timothy Michael Meier, M.D.
• Kristin Michelle Meigh, MD
• Meijer Stores Limited Partnership
• Meijer Stores Limited Partnership
• Erin Leigh Meilton, PHARM.D.
• Erin Meinert, OTD, OTR/L
• Gabriela Meinhardt
• Tamara E Meinsen, CNP

• Community/Retail Pharmacy in Columbus, OH
• Providers in Columbus, OH by specialty
• Community/Retail Pharmacy in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2014; 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.

Verify at the official NPI Registry.