Organization
MEIJER GREAT LAKES LIMITED PARTNERSHIP
Active
Other names
Meijer Pharmacy #162
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JASON BEAUCH R.PH (DIRECTOR OF PHARMACY MANAGED CARE)
(616) 791-3169
Entity
Organization
Contact information
Practice address
9905 DIXIE HWY, LOUISVILLE, KY 40272-3943
(502) 995-2110
(502) 995-2165
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
P06543
KY
3336C0003X
Community/Retail Pharmacy
Primary
P06543
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201191680A
—
IN
05
—
7100211650
—
KY
Enumeration date
09/18/2007
Last updated
03/24/2014
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us