Meijer Stores Limited Partnership
Organization Active NPI Community/Retail Pharmacy · McCordsville, IN
NPI 1982149746 · NPPES record last updated Mar 28, 2017
Key facts
- NPI
- 1982149746
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- Legal business name
- MEIJER STORES LIMITED PARTNERSHIP
- Practice address
- 6939 W Broadway
McCordsville, IN 46055-9008 - Phone
- (317) 510-0310
- Fax
- (317) 510-0265
- NPI assigned
- Jan 3, 2017
- Organization subpart
- No
Authorized official
- Name
- Jason Beauch, R.PH
- Title
- VP of Pharmacy Merchandising
- Phone
- (616) 791-3169
Other NPIs on the same Medicare enrollment 42
Corporate family (same tax ID) 14
Member of 1
Laboratory certificates & supplier records
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Meijer Stores Limited Partnership |
Epoetin|Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order)|Canes and/or Crutches|Walkers | Accepts assignment |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in IN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20111227000308 | IN | Part B Supplier - Mass Immunization (Roster Biller Only) | 2062688971 |
42 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Lafayette, IN; New Albany, IN; Muncie, IN; Mishawaka, IN; Michigan City, IN; Merrillville, IN; McCordsville, IN; Marion, IN… |
| O20170516000688 | IN | DME Supplier - Pharmacy |
2062688971 | Practice locations: McCordsville, IN |
National Provider Directory
- Tax ID family
- Meijer Stores LP
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Community/Retail Pharmacy | 3336C0003X | Yes |
Addresses
Primary practice location
6939 W Broadway
McCordsville, IN 46055-9008
Mailing address
2929 Walker Ave NW
Attn: Managed Care Government Programs
Grand Rapids, MI 49544-6402
Phone (616) 791-3169
Other names
- Meijer Pharmacy #296
Other providers in McCordsville, IN
- McCordsville Senior Living, LLC
- McDonald Family Dentistry PC
- Sara McKinniss
- Sean McNulty
- Nicole Tares McVea
- Mentoring With Magic LLC
- Daniel Meyer
- Amanda Marie Minton
- Model Homes Group Homes & Associates LLC
- Khaliphani Moyo
All providers in McCordsville, IN · Community/Retail Pharmacy in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 28, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.