| NPI | 1104196906 |
|---|---|
| NPI Type | NPI-2 Organization |
| Status | Active |
| Enumeration Date | 2012-01-10 |
| Last Updated | 2014-03-21 |
| Authorized Official | Jason Beauch Director of Pharmacy Managed Care Phone: 6167913169 |
| Mailing Address | 2929 Walker Ave Nw Grand Rapids, MI 49544-6402 United States Phone: (616) 791-3169 | Fax: (616) 735-8532 📍 View Map |
| Primary Practice Address | 4522 Elkhart Rd Goshen, IN 46526-5822 United States Phone: (574) 875-3010 | Fax: (574) 875-3065 📍 View Map |
| Issuer | State | Number | Other Issuer |
|---|---|---|---|
| MEDICAID | MI | 1104196906 | - |
| MEDICAID | IN | 201079010A | - |
| Primary | Taxonomy Code & Description | State | License Number |
|---|---|---|---|
| No | 332B00000X – Durable Medical Equipment & Medical Supplies | IN | 60004473 |
| Yes | 3336C0003X – Pharmacy, Community/Retail Pharmacy | IN | 60004473 |
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About NPI 1104196906
Meijer Stores Limited Partnership is an organization registered in the CMS NPPES NPI Registry with NPI number 1104196906. The primary specialty listed is Pharmacy, Community/Retail Pharmacy. The organization is located in Goshen, IN. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2012-01-10. All data is sourced directly from the official CMS NPPES public API and is updated daily.
Frequently Asked Questions
What is NPI 1104196906?
NPI 1104196906 belongs to Meijer Stores Limited Partnership, a Pharmacy, Community/Retail Pharmacy in Goshen, IN. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.
Is NPI 1104196906 active?
The current status of NPI 1104196906 in the NPPES registry is Active. The record was last updated on 2014-03-21.
What specialty is NPI 1104196906?
NPI 1104196906 is classified under the taxonomy Pharmacy, Community/Retail Pharmacy. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.
How do I verify NPI 1104196906?
You can verify NPI 1104196906 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.
What address is on file for NPI 1104196906?
The primary practice address on file for NPI 1104196906 is 4522 Elkhart Rd, Goshen, IN 46526-5822. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.
When was NPI 1104196906 issued?
NPI 1104196906 was first issued (enumerated) on 2012-01-10. The NPPES record was last updated on 2014-03-21.
Practice Location Map
Meijer Stores Limited Partnership is located at 4522 Elkhart Rd, Goshen, IN. Use the map below to find directions or verify the practice location.
Related Healthcare Providers
The following providers share the same practice location, specialty, or state as Meijer Stores Limited Partnership. All records sourced from the CMS NPPES registry.
License Information
The following state license numbers are on file in the NPPES registry for NPI 1104196906. For license status verification, contact the relevant state licensing board directly.
| Specialty / Taxonomy | License Number | State |
|---|---|---|
| Durable Medical Equipment & Medical Supplies | 60004473 | IN |
| Pharmacy, Community/Retail Pharmacy | 60004473 | IN |