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Organization

MEIJER, INC.

Active
Other names
Meijer Pharmacy #286
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
21431 GRAND RIVER AVE, DETROIT, MI 48219-3801
(313) 778-7610
(313) 778-7665
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
5301010661
MI
3336C0003X
Community/Retail Pharmacy
Primary
5301010661
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1275929507
MI
Enumeration date
04/14/2015
Last updated
06/19/2015
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