Organization
MEIJER, INC.
Active
Organization
MEIJER, INC.
Active
Other names
Meijer Pharmacy #465
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
100 MICHIGAN ST NE, STE. 1830, GRAND RAPIDS, MI 49503-2560
(616) 249-6210
(616) 249-6465
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
—
MI
3336C0003X
Community/Retail Pharmacy
Primary
—
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1447635388
—
MI
Enumeration date
07/21/2015
Last updated
12/17/2015
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