MEIJER PHARMACY #127
NPI 1104196906
Pharmacy - Community/Retail Pharmacy in Goshen, IN

Q: What is Meijer Stores Limited Partnership's NPI number?

The NPI number for Meijer Stores Limited Partnership is 1104196906. It was assigned to this organization in the NPPES registry on January 10, 2012. The provider is doing business as Meijer Pharmacy #127.

Q: What is Meijer Stores Limited Partnership's specialty?

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

Active since January 10, 2012CLIA 15D1008311 · Waiver

4522 ELKHART RD, GOSHEN, IN 46526(574) 875-3010(574) 875-3065 Get Directions Write a Review

NPPES record last updated: March 21, 2014. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Meijer Pharmacy #127 NPPES

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

MEIJER PHARMACY #127 (NPI 1104196906) is a healthcare organization registered as a community/retail pharmacy in Goshen, Indiana and active in the NPI registry since January 2012. The organization holds a CLIA Waiver certificate valid through January 15, 2027 and lists Jason Beauch, Director Of Pharmacy Managed Care, as its authorized official.

NPPES Registry Identity

NPI1104196906

Entity TypeOrganization

Primary Taxonomy3336C0003X

Legal Business NameMEIJER STORES LIMITED PARTNERSHIP

Location Address4522 ELKHART RDGoshen, IN 46526-5822

Mailing Address2929 Walker Ave NwGrand Rapids, MI 49544-6402 · (616) 791-3169 · Fax (616) 735-8532

Phone(574) 875-3010

Fax(574) 875-3065

Organization SubpartNo

Authorized OfficialJason BeauchDirector Of Pharmacy Managed Care · (616) 791-3169

Enumeration DateJanuary 10, 2012

Last NPPES UpdateMarch 21, 2014

✔ NPI 1104196906 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 IN · 60004473

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 60004473 (IN)

4522 ELKHART RD, Goshen, IN 46526

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Other Names 1

Doing Business AsMeijer Pharmacy #127

Other Identifiers 4

Medicaid201079010AIN

Medicare NSC6685160065IN

Medicare PINM300060375IN

Medicaid1104196906MI

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 15D1008311

Meijer Pharmacy 127 · Goshen, IN

Active · expires Jan 15, 2027

CLIA Number15D1008311

Laboratory TypePharmacy

Certificate Effective DateJanuary 16, 2025

Certificate Expiration DateJanuary 15, 2027

Laboratory DirectorJacqueline Morse

Laboratory Phone(574) 875-3010

Laboratory LocationMeijer Pharmacy 1274522 Elkhart Rd, Goshen, IN 46526

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 5

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.

347 services346 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.

332 services332 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.

248 services248 patients

Administration of pneumococcal vaccine G0009

The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.

18 services18 patients

Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677

The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.

15 services15 patients

Other Providers at the Same Location NPPES 10

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

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