Organization Active NPI

Meijer, Inc.

Doing business as Meijer Pharmacy #293

  • Community/Retail Pharmacy
  • Sault Sainte Marie, MI
National Provider Identifier
1750826525
Registry record updated Mar 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
MEIJER, INC.
Doing business as
Meijer Pharmacy #293
Practice address
1138 W 3 Mile Rd
Sault Sainte Marie, MI 49783-9132
Phone
(906) 253-2810
Fax
(906) 253-2865
NPI assigned
Jan 3, 2017
Last updated
Mar 28, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2017

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

Authorized official

Name
Jason Beauch, R.PHNPI 1518380062
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)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

1138 W 3 Mile Rd
Sault Sainte Marie, MI 49783-9132

Mailing address

2929 Walker Ave NW
Attn: Managed Care Government Programs
Grand Rapids, MI 49544-6402
Phone (616) 791-3169

Other names 1

  • Meijer Pharmacy #293 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20071022000424 MI Part B Supplier - Mass Immunization (Roster Biller Only) 8325015639 This NPI is an additional NPI on the enrollment
O20170601002909 MI DME Supplier - PharmacyDME Supplier - Department StoreDME Supplier - Grocery Store 8325015639 Practice locations: Sault Sainte Marie, MI

Laboratory certificates & supplier records

Derived by NPIMap

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

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Meijer Inc1138 W 3 Mile Rd, Sault Sainte Marie, MI 49783-9132(906) 253-2810 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 assignmentParticipating since Jan 1, 1998

National Provider Directory

National Provider Directory
Tax ID family
Meijer127 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1483401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490659200000",
    "number": "1750826525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2929 WALKER AVE NW",
            "address_2": "ATTN: MANAGED CARE GOVERNMENT PROGRAMS",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495446402",
            "telephone_number": "616-791-3169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1138 W 3 MILE RD",
            "city": "SAULT SAINTE MARIE",
            "state": "MI",
            "postal_code": "497839132",
            "telephone_number": "906-253-2810",
            "fax_number": "906-253-2865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEIJER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-03",
        "last_updated": "2017-03-28",
        "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": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Meijer Pharmacy #293",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sault Sainte Marie, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2017; 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.