Organization
MEIJER INC
Active
Organization
MEIJER INC
Active
Other names
Meijer Pharmacy #681
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH BACK RPH (DIRECTOR MANAGED CARE)
(616) 791-3485
Entity
Organization
Contact information
Practice address
15375 24 MILE ROAD, MACOMB, MI 48042
(586) 697-7410
(586) 697-7415
Mailing address
2929 WALKER AVE NW, GRAND RAPIDS, MI 49544-6402
(616) 791-3485
(616) 735-8532
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
09/28/2022
Last updated
09/28/2022
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