Organization
MEIJER INC
Active
Other names
Meijer Pharmacy #213
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
9515 BIRCH RUN ROAD, BIRCH RUN, MI 48415-9613
(989) 624-1610
(989) 624-1665
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
5301008919
MI
3336C0003X
Community/Retail Pharmacy
Primary
5301008919
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2371463
—
MI
Enumeration date
07/23/2008
Last updated
03/24/2014
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