Organization
MEIJER, INC.
Active
Other names
Meijer Pharmacy #291
Organization subpart
No
Provider details
NPI number
Authorized official
JASON BEAUCH R.PH (VP OF PHARMACY MERCHANDISING)
(616) 791-3169
Entity
Organization
Contact information
Practice address
408 W SOUTH ST, STURGIS, MI 49091-2153
(269) 319-4010
(269) 319-4065
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
5301010932
MI
3336C0003X
Community/Retail Pharmacy
Primary
5301010932
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1104287184
—
MI
05
—
201355820A
—
IN
Enumeration date
03/17/2016
Last updated
08/12/2016
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