Provider Type Icon

MEIJER GREAT LAKES LIMITED PARTNERSHIP NPI 1134556277


NPI Information

NPI: 1134556277
Provider Name: MEIJER GREAT LAKES LIMITED PARTNERSHIP

Doing Business As: MEIJER PHARMACY #269

Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

CLIA Number: 14D2066267

Address:
3649 N. VERMILION ST.
DANVILLE, IL
ZIP 61832
Phone: (217) 655-7210
Get Directions

MEIJER GREAT LAKES LIMITED PARTNERSHIP is a community/retail pharmacy pharmacy in Danville, IL. The provider is a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. MEIJER GREAT LAKES LIMITED PARTNERSHIP NPI is 1134556277. The provider is registered as an organization entity type.
The provider Is Doing Business As Meijer Pharmacy #269.

The provider's business location address is:

3649 N. VERMILION ST.
DANVILLE, IL
ZIP 61832-312
Phone: (217) 655-7210
Fax: (217) 655-7265

The provider's authorized official is Jason Beauch .
The authorized official title is Director Of Pharmacy Managed Care and has the following contact phone number (616) 791-3169.

The CLIA number assigned to this NPI record is 14D2066267 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/3/2013 and was last updated on 3/25/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1332B00000XDurable Medical Equipment & Medical Supplies054018334ILLINOISNo
23336C0003XPharmacyCommunity/Retail Pharmacy054018334ILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1201204100AMEDICAIDILLINOIS
2IL7525MEDICARE PINILLINOIS
3=========021MEDICAIDILLINOIS
46507510030MEDICARE NSCILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.