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Organization

MEIJER STORES LIMITED PARTNERSHIP

Active
Other names
Meijer Pharmacy #235
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
930 COLEMAN'S CROSSING BLVD., MARYVILLE, OH 43040-2543
(937) 553-6110
(937) 553-6165
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
022422000
OH
3336C0003X
Community/Retail Pharmacy
Primary
022422000
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0106276
OH
Enumeration date
07/02/2014
Last updated
10/29/2020
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