NPIMap

Organization Active NPI

Meijer Great Lakes LTD PT

  • Community/Retail Pharmacy
  • Dewitt, MI
National Provider Identifier
1548650146
Registry record updated Feb 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
5302040403 Issued in MI
Legal business name
MEIJER GREAT LAKES LTD PT
Practice address
12821 Cross Over Dr
Dewitt, MI 48820-7993
Phone
(517) 669-4610
NPI assigned
Feb 3, 2015
Last updated
Feb 3, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2015

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

Authorized official

Name
Elizabeth Linder
Title
Pharmacy Specialist
Phone
(517) 391-5807

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 5302040403 MI Primary

Addresses

Primary practice location

12821 Cross Over Dr
Dewitt, MI 48820-7993

Mailing address

12821 Cross Over Dr
Dewitt, MI 48820-7993

National Provider Directory

National Provider Directory
Tax ID family
Meijer Great Lakes LTD PT37 organizations share this tax ID, including this one

Other organizations with this tax ID 36

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

View all 36

NPI Registry JSON

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

{
    "created_epoch": "1422921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422921600000",
    "number": "1548650146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12821 CROSS OVER DR",
            "city": "DEWITT",
            "state": "MI",
            "postal_code": "488207993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12821 CROSS OVER DR",
            "city": "DEWITT",
            "state": "MI",
            "postal_code": "488207993",
            "telephone_number": "517-669-4610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEIJER GREAT LAKES LTD PT",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-03",
        "last_updated": "2015-02-03",
        "status": "A",
        "authorized_official_last_name": "LINDER",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "PHARMACY SPECIALIST",
        "authorized_official_telephone_number": "517-391-5807"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5302040403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dewitt, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.