Meijer Stores Limited Partnership

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

MEIJER STORES LIMITED PARTNERSHIP

Doing business as

Meijer Pharmacy #309

Practice address

9200 Mentor Ave
Mentor, OH 44060-6479

Phone

(440) 266-4410

Fax

(440) 266-4365

NPI assigned

Jan 22, 2019

Organization subpart

No

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

Authorized official

Name

Mindy Edgar, PHARMD

Title

Director of Managed Care

Phone

(616) 791-3961

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Meijer Pharmacy #309 Doing business as

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Meijer Stores Limited Partnership

  • Community/Retail Pharmacy
  • Loveland, OH
  • NPI 1366591943

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1548115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1556841600000",
    "number": "1386108520",
    "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": "9200 MENTOR AVE",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440606479",
            "telephone_number": "440-266-4410",
            "fax_number": "440-266-4365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEIJER STORES LIMITED PARTNERSHIP",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-22",
        "last_updated": "2019-05-03",
        "status": "A",
        "authorized_official_last_name": "EDGAR",
        "authorized_official_first_name": "MINDY",
        "authorized_official_title_or_position": "DIRECTOR OF MANAGED CARE",
        "authorized_official_telephone_number": "616-791-3961",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0344563",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Meijer Pharmacy #309",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Meijer Pharmacy #309",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jennifer Maria McPherson, CDCA
• Madhuri Medarametla, MD
• Medical Training Technologies LLC
• Kristi Renea Meenan
• Angela Mehalic
• Sarah Meisel, PT, DPT
• Jessica Melaragno
• Kendra Meltzer
• Karla Josmara Mendez, AA
• Mentor Chiropractic and Rehabilitation Inc

• Community/Retail Pharmacy in Mentor, OH
• Providers in Mentor, 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 May 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.