Organization
MEIJER, INC
Active
Other names
Meijer Pharmacy #045
Organization subpart
No
Provider details
NPI number
Authorized official
JASON BEAUCH RPH (DIRECTOR OF PHARMACY MANAGED CARE)
(616) 791-3169
Entity
Organization
Contact information
Practice address
217 E US HIGHWAY 223, ADRIAN, MI 49221-4215
(517) 266-2110
(517) 266-2165
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
5301003666
MI
3336C0003X
Community/Retail Pharmacy
Primary
5301003666
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0092713
—
OH
05
—
2330847
—
MI
Enumeration date
02/07/2007
Last updated
03/19/2014
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