Organization
MEIJER INC
Active
Other names
Meijer Pharmacy #187
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
595 N PINE RD, BAY CITY, MI 48708-9190
(989) 891-1510
(989) 891-1565
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
5301007118
MI
3336C0003X
Community/Retail Pharmacy
Primary
5301007118
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2360737
—
MI
Enumeration date
07/21/2006
Last updated
03/24/2014
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