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MEIJER PHARMACY #176
NPI 1013287853
Pharmacy - Community/Retail Pharmacy in Springfield, IL

Active since January 11, 2012CLIA 14D0984419 · Waiver
4200 CONESTOGA DR, SPRINGFIELD, IL 62711(217) 547-2410(217) 547-2465 Get Directions Write a Review

NPPES record last updated: March 24, 2014. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Meijer Pharmacy #176 NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MEIJER PHARMACY #176 (NPI 1013287853) is a healthcare organization registered as a community/retail pharmacy in Springfield, Illinois and active in the NPI registry since January 2012. The organization holds a CLIA Waiver certificate valid through March 20, 2027 and lists Jason Beauch, Director Of Pharmacy Managed Care, as its authorized official.

NPPES Registry Identity

NPI1013287853
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameMEIJER GREAT LAKES LIMITED PARTNERSHIP
Location Address4200 CONESTOGA DRSpringfield, IL 62711-7962
Mailing Address2929 Walker Ave NwGrand Rapids, MI 49544-6402 · (616) 791-3169 · Fax (616) 735-8532
Phone(217) 547-2410
Fax(217) 547-2465
Organization SubpartNo
Authorized OfficialJason BeauchDirector Of Pharmacy Managed Care · (616) 791-3169
Enumeration DateJanuary 11, 2012
Last NPPES UpdateMarch 24, 2014
✔ NPI 1013287853 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
License✔ Licensed in IL · 054014283
Definition
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.
Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X · License 054014283 (IL)
4200 CONESTOGA DR, Springfield, IL 62711
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Other Names 1

Doing Business AsMeijer Pharmacy #176

Other Identifiers 3

Medicaid=========016IL
Medicare PINIL7525IL
Medicare NSC6507510010IL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arizona Complete Health and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 14D0984419

Meijer Pharmacy #176 · Springfield, IL
Active · expires Mar 20, 2027
CLIA Number14D0984419
Laboratory TypePharmacy
Certificate Effective DateMarch 21, 2025
Certificate Expiration DateMarch 20, 2027
Laboratory DirectorJacqueline Morse
Laboratory Phone(217) 547-2410
Laboratory LocationMeijer Pharmacy #1764200 Conestoga Drive, Springfield, IL 62707
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
153 services153 patients
Influenza vaccine, inactivated 90653
The Influenza vaccine, inactivated, is a shot given to protect against the flu. It contains killed virus particles that help your body build immunity to the flu. It's recommended annually to keep your protection up-to-date. It's safe for ages 6 months and up.
144 services144 patients
Severe acute respiratory syndrome coronavirus 2 (covid-19) vaccine, recombinant spike protein nanoparticle, saponin-based adjuvant, preservative free, 5 mcg/0.5ml dosage, for intramuscular use 91304
The COVID-19 vaccine you'll receive is designed to protect against the virus. It contains tiny, harmless pieces of the virus's spike protein. These trigger your immune system to build a defense. The vaccine also includes a saponin-based adjuvant to enhance this response. It's given as a 0.5ml injection into a muscle.
82 services80 patients

Medical Equipment Supplier Medicare DMEPOS 9

Medicare supplier enrollment and the product categories Meijer Pharmacy #176 carries, from the Medicare DMEPOS supplier directory.

Meijer Pharmacy #176

DMEPOS supplier · Springfield, ILOperated by Meijer Great Lakes Limited Partnership
⋮

Does not accept Medicare assignment

Meijer Pharmacy #176 has not agreed to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients may be charged more than the Medicare-approved amount; confirm the expected cost with the supplier before ordering.

PTAN (Medicare Supplier Number)20312693
Medicare Participant SinceJanuary 1, 2023
Supplier Location4200 Conestoga DrSpringfield, IL 62711
Phone(217) 547-2410
Supplier Specialties
Pharmacy Department Store Grocery Store

Medicare Product Categories

Epoetin
Epoetin is a man-made version of human erythropoietin (EPO)
Immunosuppressive Drugs
Immunosuppressive drugs require dosage, frequency, and route of administration to prevent or treat the rejection of an organ transplant
Infusion Drugs
Nebulizer Drugs
Albuterol, levalbuterol, and metaproterenol are all short-acting bronchodilators with beta-adrenergic stimulatory effect
Oral Anticancer Drugs
FDA anticancer drugs
Oral Antiemetic Drugs
FDA antiemetic drugs
Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PAULA KAY HUBBARD
Nurse Practitioner
4200 CONESTOGA DR
SPRINGFIELD, IL 62711
Sangamon County (217) 321-9323
JONATHAN CULLIS PHARM. D.
Pharmacist (Pharmacotherapy)
4200 CONESTOGA DR
SPRINGFIELD, IL 62711
Sangamon County (217) 547-2410
MIRA-CLER JOY JOSAIAH
Behavior Technician
4200 CONESTOGA DR
SPRINGFIELD, IL 62711
Sangamon County (630) 286-0026

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Meijer Great Lakes Limited Partnership's NPI number?

The NPI number for Meijer Great Lakes Limited Partnership is 1013287853. It was assigned to this organization in the NPPES registry on January 11, 2012. The provider is doing business as Meijer Pharmacy #176.

Where is Meijer Great Lakes Limited Partnership located?

Meijer Great Lakes Limited Partnership is located at 4200 Conestoga Dr, Springfield, IL 62711. The listed phone number is (217) 547-2410.

What is Meijer Great Lakes Limited Partnership's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

Does Meijer Great Lakes Limited Partnership accept Medicare assignment for medical equipment?

No. As a Medicare medical equipment supplier, Meijer Pharmacy #176 does not accept Medicare assignment for equipment and supplies, so patients may be charged more than the Medicare-approved amount. Confirm the expected cost with the supplier before ordering.

Does Meijer Great Lakes Limited Partnership hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 14D0984419) is associated with this NPI, valid through March 20, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Meijer Great Lakes Limited Partnership accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter Health of Delaware, Ambetter from Absolute Total Care and Ambetter from Arizona Complete Health and 48 other insurers list Meijer Great Lakes Limited Partnership as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Meijer Great Lakes Limited Partnership was last updated on March 24, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.