Organization
MEIJER STORES LIMITED PARTNERSHIP
Active
Other names
Meijer Pharmacy #305
Organization subpart
No
Provider details
NPI number
Authorized official
MINDY EDGAR PHARMD (DIRECTOR OF MANAGED CARE)
(616) 791-3961
Entity
Organization
Contact information
Practice address
924 N TAYLOR DR, SHEBOYGAN, WI 53081-4202
(920) 547-2610
(920) 547-2595
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
—
100087149
—
WI
Enumeration date
01/09/2019
Last updated
05/02/2019
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