Organization
MEIJER STORES LIMITED PARTNERSHIP
Active
Other names
Meijer Pharmacy #283
Organization subpart
No
Provider details
NPI number
Authorized official
JASON BEAUCH R.PH (DIRECTOR OF PHARMACY MANAGED CARE)
(616) 791-3169
Entity
Organization
Contact information
Practice address
171 W TOWN SQUARE WAY, OAK CREEK, WI 53154-6801
(414) 501-1710
(414) 768-7365
Mailing address
2929 WALKER AVE NW, GRAND RAPIDS, MI 49544-6402
(616) 791-3169
(616) 735-8532
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
WI
3336C0003X
Community/Retail Pharmacy
Primary
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100046343
—
WI
Enumeration date
06/01/2015
Last updated
09/01/2015
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