Organization
MEIJER GREAT LAKES LIMITED PARTNERSHIP
Active
Other names
Meijer Pharmacy # 301
Organization subpart
No
Provider details
NPI number
Authorized official
IAN NAGY (MANAGER, THIRD PARTY GOVT. PROGRAMS)
(616) 249-6272
Entity
Organization
Contact information
Practice address
990 N KINZIE AVE, BRADLEY, IL 60915
(779) 301-8210
(779) 301-8265
Mailing address
2929 WALKER AVE NW, GRAND RAPIDS, MI 49544-6402
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
02/08/2018
Last updated
09/07/2021
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