# MEIJER STORES LIMITED PARTNERSHIP

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Meijer Pharmacy \#309
- **Organization subpart:** No

## Provider details

- **NPI number:** 1386108520
- **Authorized official:** MINDY EDGAR PHARMD (DIRECTOR OF MANAGED CARE)
- **Authorized official phone:** (616) 791-3961

## Contact information

- **Practice address:** 9200 MENTOR AVE, MENTOR, OH 44060-6479
- **Practice address phone:** (440) 266-4410
- **Practice address fax:** (440) 266-4365
- **Mailing address:** 2929 WALKER AVE NW, GRAND RAPIDS, MI 49544-6402

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 01/22/2019
- **Last updated:** 05/03/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0344563 | — | OH |