MEIJER GREAT LAKES LIMITED PARTNERSHIP (NPI# 1790971380) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790971380 |
| Entity Type | Organization |
| Organization Name | MEIJER GREAT LAKES LIMITED PARTNERSHIP |
| Other Organization Name | MEIJER PHARMACY #162 |
| Practice Address |
9905 Dixie Hwy Louisville KY 40272-3943 |
| Mailing Address |
2929 Walker Ave Nw Grand Rapids MI 49544-9424 |
| Practice Telephone | 5029952110 |
| Practice Fax Number | 5029952165 |
| Mailing Telephone | 6167913169 |
| Mailing Fax Number | 6167358532 |
| Enumeration Date | 2007-09-18 |
| Last Update Date | 2014-03-24 |
| Authorized Official Name | MR. JASON BEAUCH (DIRECTOR OF PHARMACY MANAGED CARE) |
| Authorized Official Telephone | 6167913169 |
| Authorized Official Credential | R.PH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | P06543 | KY | Suppliers |
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
P06543 | KY | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 7100211650 | 05 | |
| IN | 201191680A | 05 |
| Other Name | Type Code |
|---|---|
| Meijer Pharmacy #162 | 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 |
9905 DIXIE HWY |
| City | LOUISVILLE |
| State | KY |
| Zip Code | 40272-3943 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689873903 | Samantha Hammond | Pharmacist | 9905 Dixie Hwy, Louisville, KY 40272-3943 | 2007-07-16 |
| 1669963310 | Lyndsey Alyse Riddell | Pharmacist | 9905 Dixie Hwy, Louisville, KY 40272-3943 | 2018-05-29 |
| 1649721705 | Cassandra Silkowski | Pharmacist | 9905 Dixie Hwy, Louisville, KY 40272-3943 | 2016-10-24 |
| 1003226804 | Jeffrey Tate | Pharmacist | 9905 Dixie Hwy, Louisville, KY 40272-3943 | 2014-05-01 |
| 1821412248 | Gregg Behrend | Pharmacist | 9905 Dixie Hwy, Louisville, KY 40272-3943 | 2014-02-05 |
| 1831511021 | Crystal Isaacs | Pharmacist | 9905 Dixie Hwy, Louisville, KY 40272-3943 | 2014-01-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649795105 | Jewell Elizabeth Berger | Occupational Therapist | 9700 Stone Street Rd, Louisville, KY 40272 | 2017-08-07 |
| 1235668658 | Jessica Cook | Occupational Therapy Assistant | 12420 Hedgeapple Way, Louisville, KY 40272 | 2017-06-08 |
| 1033468525 | Shawn Thomas Benningfield | Counselor | 9702 Stonestreet Rd Ste 120, Louisville, KY 40272 | 2012-08-30 |
| 1386956415 | Jeannette M Martin | Marriage & Family Therapist | 9800 Stonestreet Rd, Louisville, KY 40272 | 2010-07-06 |
| 1437346145 | Community Family Living, LLC | Day Training, Developmentally Disabled Services | 610 Valley College Dr., Louisville, KY 40272 | 2007-09-26 |
| 1982797403 | William Spencer Shipley | Dentist | 9900 Old Third Street Road, Louisville, KY 40272 | 2006-10-02 |
| 1962513317 | Teresa May Wright | Nurse Practitioner | 1912 Penile Rd, Valley Station, KY 40272 | 2006-08-31 |
| 1710400734 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 701 Valley College Dr, Louisville, KY 40272 | 2017-07-21 |
| 1952851859 | Renew Recovery, LLC | Substance Abuse Rehabilitation Facility | 9702 Stonestreet Rd, Suite 120, Louisville, KY 40272 | 2016-10-04 |
| 1780090233 | Umama Sadia | Family Medicine | 9702 Stonestreet Rd, Louisville, KY 40272 | 2014-07-05 |
| Find all providers in zip 40272 | ||||
| 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 |
|---|---|---|---|---|
| 1306445259 | Middletown Pharmacist Group | Pharmacy | 11601 Shelbyville Rd Ste B, Louisville, KY 40243-1309 | 2020-10-21 |
| 1497361208 | Kerry Hettinger | Pharmacy | 1114 Schiller Ave, Louisville, KY 40204-1946 | 2020-09-17 |
| 1922629997 | Classic Specialty Pharmacy Pllc | Pharmacy | 3582 Springhurst Blvd, Louisville, KY 40241-4141 | 2020-05-01 |
| 1346860095 | Dupont Pharmacy, LLC | Pharmacy | 3924 S Dupont Sq Ste D, Louisville, KY 40207-5912 | 2020-04-23 |
| 1528619806 | Lifewell Rx Pharmacy | Pharmacy | 2200 Buechel Ave Ste 104, Louisville, KY 40218-2664 | 2019-09-27 |
| 1407367410 | St Matthews Specialty Pharmacy Pllc | Pharmacy | 3922b Willis Ave, Louisville, KY 40207-4911 | 2017-10-17 |
| 1043675507 | New Life Pharmacy Inc | Pharmacy | 5721 Preston Hwy, Louisville, KY 40219-1305 | 2015-12-28 |
| 1811378524 | East Louisville Interventional Pain Specialists Pllc | Pharmacy | 4205 Springhurst Blvd Ste 101, Louisville, KY 40241-6159 | 2015-06-18 |
| 1851641666 | The Tamarkin Company | Pharmacy | 108 W Main Street, Louisville, OH 44641-1226 | 2012-09-19 |
| 1801161732 | Parmiss Corp | Pharmacy | 10278 Shelbyville Rd, Louisville, KY 40223-2955 | 2012-03-10 |
| Find all providers in LOUISVILLE | ||||
| City | LOUISVILLE |
| Zip Code | 40272 |
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.