Organization
MEIJER STORES LIMITED PARTNERSHIP
Active
Other names
Meijer Pharmacy #308
Organization subpart
No
Provider details
NPI number
Authorized official
RAYMOND BURZYNSKI PHARMD (DIRECTOR OF MANAGED CARE)
(616) 249-6583
Entity
Organization
Contact information
Practice address
1810 NAGEL RD, AVON, OH 44011
(440) 695-2450
(440) 695-2465
Mailing address
2929 WALKER AVE NW, GRAND RAPIDS, MI 49544-6402
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
—
0344503
—
OH
Enumeration date
01/23/2019
Last updated
09/17/2019
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