Organization
MEIJER GREAT LAKES LIMITED PARTNERSHIP
Active
Other names
Meijer Pharmacy #262
Organization subpart
No
Provider details
NPI number
Authorized official
IAN NAGY RPH (MANAGED CARE GOVERNMENT CONTRACTING)
(616) 249-6272
Entity
Organization
Contact information
Practice address
15701 S 71ST CT, ORLAND PARK, IL 60462-6800
(708) 342-9910
(708) 342-9965
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
054017480
IL
3336C0003X
Community/Retail Pharmacy
Primary
054017480
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201191620A
—
IN
Enumeration date
01/10/2012
Last updated
09/07/2021
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