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Organization

MEIJER STORES LIMITED PARTNERSHIP

Active
Other names
Meijer Pharmacy #066
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
1500 HILLCREST AVE, SPRINGFIELD, OH 45504-1570
(937) 327-2010
(937) 327-2065
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
02597800
OH
3336C0003X
Community/Retail Pharmacy
Primary
02597800
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0770778
OH
Enumeration date
02/07/2007
Last updated
03/17/2014
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