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MEIJER PHARMACY #121
NPI 1932479730
Pharmacy - Community/Retail Pharmacy in Mishawaka, IN

Active since January 10, 2012CLIA 15D1008317 · Waiver
5020 GRAPE RD, MISHAWAKA, IN 46545(574) 273-3510(574) 273-3565 Get Directions Write a Review

NPPES record last updated: March 19, 2014. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Meijer Pharmacy #121 NPPES

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

MEIJER PHARMACY #121 (NPI 1932479730) is a healthcare organization registered as a community/retail pharmacy in Mishawaka, 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

NPI1932479730
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameMEIJER STORES LIMITED PARTNERSHIP
Location Address5020 GRAPE RDMishawaka, IN 46545-8708
Mailing Address2929 Walker Ave NwGrand Rapids, MI 49544-6402 · (616) 791-3169 · Fax (616) 735-8532
Phone(574) 273-3510
Fax(574) 273-3565
Organization SubpartNo
Authorized OfficialJason BeauchDirector Of Pharmacy Managed Care · (616) 791-3169
Enumeration DateJanuary 10, 2012
Last NPPES UpdateMarch 19, 2014
✔ NPI 1932479730 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 · 60004277
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 60004277 (IN)
5020 GRAPE RD, Mishawaka, IN 46545
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Other Names 1

Doing Business AsMeijer Pharmacy #121

Other Identifiers 4

Medicaid1932479730MI
Medicare NSC6685160050IN
Medicare PINM300060375IN
Medicaid201079020AIN

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 15D1008317

Meijer Pharmacy 121 · Mishawaka, IN
Active · expires Jan 15, 2027
CLIA Number15D1008317
Laboratory TypePharmacy
Certificate Effective DateJanuary 16, 2025
Certificate Expiration DateJanuary 15, 2027
Laboratory DirectorJacqueline Morse
Laboratory Phone(574) 273-3510
Laboratory LocationMeijer Pharmacy 1215020 Grape Rd, Mishawaka, IN 46545
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 4

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.
290 services288 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.
276 services276 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.
174 services174 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

Other Providers at the Same Location NPPES 7

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

MRS. BETH ANN LONGBRAKE
Pharmacist (Pharmacotherapy)
5020 GRAPE RD
MISHAWAKA, IN 46545
St. Joseph County (574) 273-3533
MICHAEL KREMPEC
Pharmacist
5020 GRAPE RD
MISHAWAKA, IN 46545
St. Joseph County (574) 273-3510
ERIN PAYNICH
Pharmacist
5020 GRAPE RD
MISHAWAKA, IN 46545
St. Joseph County (574) 273-3510
RAMANDEEP SOHI PHARMD, MBA
Pharmacist
5020 GRAPE RD
MISHAWAKA, IN 46545
St. Joseph County (574) 273-3510
REBECCA HARTNAGEL
Pharmacist
5020 GRAPE RD
MISHAWAKA, IN 46545
St. Joseph County (574) 273-3510
MIKE THOMPSON
Pharmacist
5020 GRAPE RD
MISHAWAKA, IN 46545
St. Joseph County (574) 273-3520
DR. AUGUSTINE CONG BUI PHARMD
Pharmacist
5020 GRAPE RD
MISHAWAKA, IN 46545
St. Joseph County (574) 273-3510

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 Stores Limited Partnership's NPI number?

The NPI number for Meijer Stores Limited Partnership is 1932479730. It was assigned to this organization in the NPPES registry on January 10, 2012. The provider is doing business as Meijer Pharmacy #121.

Where is Meijer Stores Limited Partnership located?

Meijer Stores Limited Partnership is located at 5020 Grape Rd, Mishawaka, IN 46545. The listed phone number is (574) 273-3510.

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.

Does Meijer Stores Limited Partnership hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 15D1008317) is associated with this NPI, valid through January 15, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Meijer Stores 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 49 other insurers list Meijer Stores 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 Stores Limited Partnership was last updated on March 19, 2014. NPI Profile syncs with the weekly NPPES data releases published by CMS.