Organization
MEIJER GREAT LAKES LIMITED PARTNERSHIP
Active
Other names
Meijer Pharmacy #313
Organization subpart
No
Provider details
NPI number
Authorized official
RAYMOND BURZYNSKI (DIRECTOR OF MANAGED CARE)
(616) 249-6583
Entity
Organization
Contact information
Practice address
541 PURI PKWY, SYCAMORE, IL 60178-9029
(815) 991-1210
(815) 991-1232
Mailing address
2929 WALKER AVE NW, GRAND RAPIDS, MI 49544-6402
(616) 791-3485
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
02/04/2020
Last updated
02/25/2021
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