Meijer Pharmacy #120
LBN: Meijer Stores Limited Partnership
Meijer Pharmacy #120 is an health care organization with primary practice located at 3600 Portage Rd , South Bend IN 46628. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty.
Meijer Stores Limited Partnership can be contacted via phone (574) 273-3410, or through Beauch, Jason via phone (616) 791-3169.
Contact Information
Primary practice address
3600 Portage Rd
South Bend IN 46628
Phone: (574) 273-3410
Fax: (574) 273-3465
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Durable Medical Equipment & Medical Supplies | 332B00000X | 60004375 | Indiana |
| Suppliers / Community/Retail Pharmacy | 3336C0003X | 60004375 | Indiana |
Profile Details
| NPI number | 1033489844 |
|---|---|
| LBN Legal business name | Meijer Stores Limited Partnership |
| DBA Doing business as | Meijer Pharmacy #120 |
| Authorized official | Beauch, Jason RPH |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jan 10th, 2012 |
| Last updated | Mar 19th, 2014 - about 10 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1033489844 | NPPES |
| Michigan | MEDICAID | 1033489844 | |
| Michigan | MEDICAID | 201079210A |
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