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MEIJER STORES LIMITED PARTNERSHIP NPI 1578834974


NPI Information

NPI: 1578834974
Provider Name: MEIJER STORES LIMITED PARTNERSHIP

Doing Business As: MEIJER PHARMACY #124

Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

CLIA Number: 15D1008315

Address:
6309 LIMA RD
FORT WAYNE, IN
ZIP 46818
Phone: (260) 497-1010
Get Directions

MEIJER STORES LIMITED PARTNERSHIP is a community/retail pharmacy pharmacy in Fort Wayne, IN. 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 STORES LIMITED PARTNERSHIP NPI is 1578834974. The provider is registered as an organization entity type.
The provider Is Doing Business As Meijer Pharmacy #124.

The provider's business location address is:

6309 LIMA RD
FORT WAYNE, IN
ZIP 46818-425
Phone: (260) 497-1010
Fax: (260) 497-1065

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 15D1008315 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/18/2012 and was last updated on 5/30/2013.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1332B00000XDurable Medical Equipment & Medical Supplies60004404INDIANANo
23336C0003XPharmacyCommunity/Retail Pharmacy60004404INDIANAYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
16685160020MEDICARE NSCINDIANA
2M300060375MEDICARE PININDIANA
3201079240AMEDICAIDINDIANA

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: 4/28/2024

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