Organization
MEIJER STORES LIMITED PARTNERSHIP
Active
Other names
Meijer Pharmacy #115
Organization subpart
No
Provider details
NPI number
Authorized official
JASON BEAUCH RPH (DIRECTOR OF PHARMACY MANAGED CARE)
(616) 791-3169
Entity
Organization
Contact information
Practice address
1391 CONANT ST, MAUMEE, OH 43537-1609
(419) 891-8710
(419) 891-8765
Mailing address
2929 WALKER AVE NW, GRAND RAPIDS, MI 49544-9424
(616) 791-3169
(616) 735-8532
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
02723850
OH
3336C0003X
Community/Retail Pharmacy
Primary
02723850
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0913702
—
OH
05
—
1114014362
—
MI
Enumeration date
10/09/2006
Last updated
03/19/2014
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