Organization
MEIJER STORES LIMITED PARTNERSHIP
Active
Other names
Meijer Pharmacy #300
Organization subpart
No
Provider details
NPI number
Authorized official
JASON BEAUCH (VICE PRESIDIENT OF PHARMACY)
(616) 735-8014
Entity
Organization
Contact information
Practice address
3801 N. RICHMOND STREET, GRAND CHUTE, WI 54913
(920) 350-6210
(920) 350-6265
Mailing address
2929 WALKER AVE NW, GRAND RAPIDS, MI 49544-6402
(616) 791-5032
(616) 735-8532
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100077010
—
WI
Enumeration date
02/28/2018
Last updated
06/20/2018
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