MEIJER GREAT LAKES LIMITED PARTNERSHIP (NPI# 1013287853) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013287853 |
| Entity Type | Organization |
| Organization Name | MEIJER GREAT LAKES LIMITED PARTNERSHIP |
| Other Organization Name | MEIJER PHARMACY #176 |
| Practice Address |
4200 Conestoga Dr Springfield IL 62711-7962 |
| Mailing Address |
2929 Walker Ave Nw Grand Rapids MI 49544-6402 |
| Practice Telephone | 2175472410 |
| Practice Fax Number | 2175472465 |
| Mailing Telephone | 6167913169 |
| Mailing Fax Number | 6167358532 |
| Enumeration Date | 2012-01-11 |
| Last Update Date | 2014-03-24 |
| Authorized Official Name | JASON BEAUCH (DIRECTOR OF PHARMACY MANAGED CARE) |
| Authorized Official Telephone | 6167913169 |
| Authorized Official Credential | RPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | 054014283 | IL | Suppliers |
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
054014283 | IL | Suppliers |
| Other Name | Type Code |
|---|---|
| Meijer Pharmacy #176 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225669641 | Meijer Great Lakes Limited Partnership | Durable Medical Equipment & Medical Supplies | 541 Puri Pkwy, Sycamore, IL 60178-9029 | 2020-02-04 |
| 1962866525 | Meijer Great Lakes Limited Partnership | Durable Medical Equipment & Medical Supplies | 3800 Vollmer Rd, Flossmoor, IL 60422-1274 | 2016-04-11 |
| 1891159455 | Meijer Great Lakes Limited Partnership | Durable Medical Equipment & Medical Supplies | 750 E Rollins Rd, Round Lake Beach, IL 60073-1340 | 2016-04-11 |
| 1518328806 | Meijer Great Lakes Limited Partnership | Durable Medical Equipment & Medical Supplies | 2951 Heartland Crossing Blvd, Owensboro, KY 42303-7669 | 2016-03-14 |
| 1114314986 | Meijer Great Lakes Limited Partnership | Durable Medical Equipment & Medical Supplies | 1770 West Lane, Machesney Park, IL 61115-1627 | 2015-04-20 |
| 1205223070 | Meijer Great Lakes Limited Partnership | Durable Medical Equipment & Medical Supplies | 2013 Mcfarland Road, Rockford, IL 61107-6835 | 2015-04-20 |
| 1649686056 | Meijer Great Lakes Limited Partnership | Durable Medical Equipment & Medical Supplies | 11305 Lincoln Rd., Mokena, IL 60448-2070 | 2014-07-07 |
| 1346650850 | Meijer Great Lakes Limited Partnership | Durable Medical Equipment & Medical Supplies | 1676 Westpark Dr., Bowling Green, KY 42104-4712 | 2014-05-06 |
| 1134556277 | Meijer Great Lakes Limited Partnership | Durable Medical Equipment & Medical Supplies | 3649 N. Vermilion St., Danville, IL 61832-1312 | 2013-10-03 |
| 1417398082 | Meijer Great Lakes Limited Partnership | Durable Medical Equipment & Medical Supplies | 9200 S Western Ave, Evergreen Park, IL 60805-2500 | 2013-07-11 |
| Street Address |
4200 CONESTOGA DR |
| City | SPRINGFIELD |
| State | IL |
| Zip Code | 62711-7962 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023517109 | Paula Kay Hubbard | Nurse Practitioner | 4200 Conestoga Dr, Springfield, IL 62711-7962 | 2018-02-05 |
| 1265965800 | Juliet Anne Oury | Nurse Practitioner | 4200 Conestoga Dr, Springfield, IL 62711-7962 | 2017-04-11 |
| 1760925697 | Landon Conrad | Pharmacist | 4200 Conestoga Dr, Springfield, IL 62711-7962 | 2016-11-25 |
| 1053721480 | Jonathan Cullis | Pharmacist | 4200 Conestoga Dr, Springfield, IL 62711-7962 | 2014-05-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578057220 | Merissa Pryor | Social Worker | 4200 Conestoga Drive, Mbn 120, Springfield, IL 62711 | 2018-06-17 |
| 1255884623 | Dental Professionals of Illinois, P.C. | Dentist | 2740 Prairie Crossing Drive, Springfield, IL 62711 | 2016-08-02 |
| 1841682424 | Americare At Centennial Pointe Assisted Living LLC | Assisted Living Facility | 3440 Hedley Road, Springfield, IL 62711 | 2015-02-19 |
| 1306249248 | Schon Dental, LLC | Dentist | 2809 Mansion Road Suite D, Springfield, IL 62711 | 2014-10-07 |
| 1891105490 | John Weiss | Pharmacist | 4200 Conestoga Drive, Springfield, IL 62711 | 2014-05-05 |
| 1720350689 | Victor Harold Lary | Family Medicine | 3251 Spaulding Orchard Road, Springfield, IL 62711 | 2012-02-07 |
| 1902181795 | Amanda Rose Davis | Pharmacist | 2500 Koke Mill Rd, Springfield, IL 62711 | 2011-10-12 |
| 1316233703 | Karen Zerkle | Dentist | 2809 Mansion Rd, Suite D, Springfield, IL 62711 | 2011-06-23 |
| 1255520557 | Link Chiropractic LLC | Chiropractor | 7012 Kingsmill Ct, Springfield, IL 62711 | 2007-10-23 |
| 1669688230 | Victoria Lynn Driskill | Dentist | 4701 W. Wabash Ave, Springfield, IL 62711 | 2007-05-14 |
| Find all providers in zip 62711 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| 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. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386205524 | Quinate Pharmacy LLC | Pharmacy | 1569 Ga Highway 21 S, Springfield, GA 31329-5214 | 2019-06-27 |
| 1295209443 | St Johns Hospital of The Hospital Sisters of The Third Order of St F | Pharmacy | 400 N 9th St Ste 1500, Springfield, IL 62702-5310 | 2019-01-21 |
| 1770093122 | Genoa Healthcare, LLC | Pharmacy | 417 Liberty St Ste 1b, Springfield, MA 01104-3739 | 2017-10-11 |
| 1316483266 | Springfield Clinic, LLP | Pharmacy | 900 N 1st St Rm 4066, Springfield, IL 62702-3749 | 2017-01-17 |
| 1194277681 | Grove Professional Pharmacy, Inc | Pharmacy | 1636 S Glenstone Ave Ste 108, Springfield, MO 65804-1512 | 2016-10-31 |
| 1962852012 | Main Sail Enterprises South LLC | Pharmacy | 222 E Primrose St Ste B, Springfield, MO 65807-5233 | 2016-06-20 |
| 1588042816 | Main Sail Enterprises-downtown LLC | Pharmacy | 655 S Campbell Ave, Springfield, MO 65806-2901 | 2015-05-06 |
| 1972901189 | Fred's Stores of Tennessee Inc | Pharmacy | 1117 Lincoln Park Rd, Springfield, KY 40069 | 2014-12-22 |
| 1417363516 | Springfield Family Pharmacy, Inc | Pharmacy | 175 Carew St, Suite 100, Springfield, MA 01104 | 2014-07-09 |
| 1932529716 | Walgreen Co | Pharmacy | 440 E Tampa St Ste 100, Springfield, MO 65806-1131 | 2014-04-21 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 62711 |
Please comment or provide details below to improve the information on MEIJER GREAT LAKES LIMITED PARTNERSHIP.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.