Meijer Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5301005162 Issued in MI

Legal business name

MEIJER INC

Doing business as

Meijer Pharmacy #063

Practice address

30800 Little Mack Ave
Roseville, MI 48066-1700

Phone

(586) 415-6110

Fax

(586) 415-6165

NPI assigned

Feb 7, 2007

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 #063 Doing business as

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mario Angelo Aiosa, R.PH.

  • Pharmacotherapy Pharmacist
  • Roseville, MI
  • NPI 1700296662
  NPD (past)
• Max Ameye

  • Pharmacist
  • Roseville, MI
  • NPI 1740899426
  NPD (past)
• David Filimon, PHARMD

  • Pharmacist
  • Roseville, MI
  • NPI 1326499112
  NPD (past)
• Paula Spear, PHARM.D, RPH

  • Pharmacotherapy Pharmacist
  • Roseville, MI
  • NPI 1790195329
  NPD (past)
• Erin Young, PHARM D

  • Pharmacist
  • Roseville, MI
  • NPI 1841640042
  NPD (past)

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395014400000",
    "number": "1831239334",
    "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": "30800 LITTLE MACK AVE",
            "city": "ROSEVILLE",
            "state": "MI",
            "postal_code": "480661700",
            "telephone_number": "586-415-6110",
            "fax_number": "586-415-6165"
        }
    ],
    "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": "5301005162",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301005162",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2345002",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Meijer Pharmacy #063",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Yvette McCoy-Rodgers
• McGettrick Dental Management, PLLC
• Tyra Lajoy McKinley, LPN
• Emily S McManaman, M.A, BCBA, LBA
• Haresh S Mehta, M.D.
• Denurah Menanndruzz
• Alexandria Mendola, AGACNP-BC
• Mental Wellness Group LLC
• Francine Mercene, PHARMD
• Mercy Medical Pharmacy , LLC

• Community/Retail Pharmacy in Roseville, MI
• Providers in Roseville, MI by specialty
• Community/Retail Pharmacy in Michigan

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.