Organization
MEIJER STORES LIMITED PARTNERSHIP
Active
Other names
Meijer Pharmacy #304
Organization subpart
No
Provider details
NPI number
Authorized official
RAYMOND BURZYNSKI (DIRECTOR OF PHARMACY MANAGED CARE)
(616) 249-6583
Entity
Organization
Contact information
Practice address
1818 S. RAPIDS RD, MANITOWOC, WI 54220-9302
(920) 663-3846
(920) 663-3865
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
02/07/2020
Last updated
07/09/2020
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