Organization
MEIJER STORES LIMITED PARTNERSHIP
Active
Other names
Meijer Pharmacy #463
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN HURN R.PH (DIRECTOR, PHARMACY ADMINISTRATION)
(616) 791-5185
Entity
Organization
Contact information
Practice address
1515 PROFIT DR, FORT WAYNE, IN 46808-1172
(260) 310-6420
(260) 471-5170
Mailing address
2929 WALKER AVE NW, GRAND RAPIDS, MI 49544-6402
(616) 791-5185
(616) 735-8532
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
60006321A
—
3336C0003X
Community/Retail Pharmacy
Primary
60006321A
—
Other
Enumeration date
12/05/2012
Last updated
12/05/2012
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