Organization
MEIJER STORES LIMITED PARTNERSHIP
Active
Other names
Meijer Pharmacy #104
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
1661 HILLIARD ROME RD, COLUMBUS, OH 43228-9485
(614) 529-5110
(614) 529-5165
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
02687900
OH
3336C0003X
Community/Retail Pharmacy
Primary
02-687900
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0856926
—
OH
Enumeration date
10/09/2006
Last updated
03/17/2014
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