# MEIJER STORES LIMITED PARTNERSHIP

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Meijer Pharmacy \#300
- **Organization subpart:** No

## Provider details

- **NPI number:** 1659872240
- **Authorized official:** JASON BEAUCH (VICE PRESIDIENT OF PHARMACY)
- **Authorized official phone:** (616) 735-8014

## Contact information

- **Practice address:** 3801 N. RICHMOND STREET, GRAND CHUTE, WI 54913
- **Practice address phone:** (920) 350-6210
- **Practice address fax:** (920) 350-6265
- **Mailing address:** 2929 WALKER AVE NW, GRAND RAPIDS, MI 49544-6402
- **Mailing address phone:** (616) 791-5032
- **Mailing address fax:** (616) 735-8532

## Taxonomy

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

## Other

- **Enumeration date:** 02/28/2018
- **Last updated:** 06/20/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100077010 | — | WI |