Meijer Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5301005713 Issued in MI

Legal business name

MEIJER INC

Doing business as

Meijer Pharmacy #109

Practice address

1703 Haggerty Hwy
Commerce Township, MI 48390-2833

Phone

(248) 926-3110

Fax

(248) 926-3165

NPI assigned

Dec 22, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Jason Beauch, R.PH

Title

Director of Pharmacy Managed Care

Phone

(616) 791-3169

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Meijer Pharmacy #109 Doing business as

Medicare fee-for-service enrollment

Enrolled in MI2 enrollments

Enrollment records 2

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

CLIA laboratory certificates

Medicare medical equipment & supply locations

Tax ID family

Meijer127 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 17

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

• Meijer

  • Pharmacy
  • Dewitt, MI
  • NPI 1952717340
  NPD tax ID
• Meijer Inc

  • Community/Retail Pharmacy
  • Charlotte, MI
  • NPI 1831253236
  NPD tax ID
• Meijer Inc

  • Community/Retail Pharmacy
  • Grandville, MI
  • NPI 1841355716
  NPD tax ID
• Meijer Inc

  • Community/Retail Pharmacy
  • Flint, MI
  • NPI 1861532319
  NPD tax ID
• Meijer Inc

  • Community/Retail Pharmacy
  • Cedar Springs, MI
  • NPI 1881834455
  NPD tax ID
• Meijer Inc

  • Community/Retail Pharmacy
  • Wixom, MI
  • NPI 1902955321
  NPD tax ID
• Meijer Inc

  • Community/Retail Pharmacy
  • Battle Creek, MI
  • NPI 1912046111
  NPD tax ID
• Meijer Inc

  • Community/Retail Pharmacy
  • Wyoming, MI
  • NPI 1942340484
  NPD tax ID
• Meijer Inc

  • Community/Retail Pharmacy
  • Jenison, MI
  • NPI 1942349824
  NPD tax ID
• Meijer Inc

  • Community/Retail Pharmacy
  • Livonia, MI
  • NPI 1942364336
  NPD tax ID
• Meijer Inc

  • Community/Retail Pharmacy
  • Hartland, MI
  • NPI 1942431093
  NPD tax ID
• Meijer Inc

  • Community/Retail Pharmacy
  • Canton, MI
  • NPI 1972642874
  NPD tax ID

Locations

Practitioners 1

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

• Jyotika Harish Mistry

  • Pharmacist
  • Commerce Township, MI
  • NPI 1760630487
  NPD (past)

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

{
    "created_epoch": "1166745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395014400000",
    "number": "1942365739",
    "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": "1703 HAGGERTY HWY",
            "city": "COMMERCE TOWNSHIP",
            "state": "MI",
            "postal_code": "483902833",
            "telephone_number": "248-926-3110",
            "fax_number": "248-926-3165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEIJER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-22",
        "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_name_prefix": "Mr.",
        "authorized_official_credential": "R.PH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MI",
            "license": "5301005713",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301005713",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2349935",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Meijer Pharmacy #109",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jessica Patricia Martinez, OTR/L
• Dakota Mayville
• Kelly Jayne McCarthy, NP
• Kara L McGahey, FNP-BC, RN
• Larissa Alexandra McMahon, D.C.
• Mercy Medical Group
• Mercy Medical Group-Pediatrics
• Salima Meskine, M.D.
• Dorothy Angela Mezza, R.PH.
• Mi Home Therapy Solutions LLC

• Community/Retail Pharmacy in Commerce Township, MI
• Providers in Commerce Township, 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.
• 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.