Meijer

Primary specialty

Point of ServiceTaxonomy code 305S00000X

License

051.295682 Issued in IL

Legal business name

MEIJER

Practice address

755 E Boughton Rd
Bolingbrook, IL 60440-2250

Phone

(630) 783-5365

NPI assigned

May 5, 2014

Last updated

May 5, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Mohsen Baidoun, PHARMDNPI 1740568260

Title

Staff Pharmacist

Phone

(313) 974-1821

Specialties & licenses 1

Addresses

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.

• Mohsen Baidoun, RPH

  • Pharmacist
  • Dearborn, MI
  • NPI 1740568260
  Authorized official Same address or phone

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

{
    "created_epoch": "1399248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399248000000",
    "number": "1861802456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2825 GABRIELLA ST",
            "address_2": "APT 403",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605153888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 E BOUGHTON RD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604402250",
            "telephone_number": "630-783-5365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEIJER",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-05",
        "last_updated": "2014-05-05",
        "status": "A",
        "authorized_official_last_name": "BAIDOUN",
        "authorized_official_first_name": "MOHSEN",
        "authorized_official_title_or_position": "STAFF PHARMACIST",
        "authorized_official_telephone_number": "313-974-1821",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "IL",
            "license": "051.295682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Meher Bala Medavaram, M.D.
• Medic Home Health Care, LLC
• Medical Home Care Inc
• Denise Meginniss, LCPC
• Sanjay Mehta, DDS
• Meijer Great Lakes Limited Partnership (Meijer Pharmacy #169)
• Meijer Great Lakes Limited Partnership (Meijer Pharmacy #215)
• Jessica Melendez, MS, LAT, ATC
• Meli Development Center
• Christina Tingson Mercado

• Point of Service in Bolingbrook, IL
• Providers in Bolingbrook, IL by specialty
• Point of Service in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2014; 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.