Organization
MEIJER STORES LIMITED PARTNERSHIP
Active
Other names
Meijer Pharmacy #106
Organization subpart
No
Provider details
NPI number
Authorized official
JASON BEAUCH R.PH (DIRECTOR OF PHARMACY MANAGED CARE)
(616) 791-3169
Entity
Organization
Contact information
Practice address
9200 N MAIN ST, ENGLEWOOD, OH 45415-1125
(937) 832-5110
(937) 832-5165
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
02661750
OH
3336C0003X
Community/Retail Pharmacy
Primary
02661750
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0823827
—
OH
Enumeration date
12/22/2006
Last updated
09/23/2014
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