Organization
MEIJER, INC.
Active
Organization
MEIJER, INC.
Active
Other names
Meijer Pharmacy #271
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
1223 PHOENIX ST., SOUTH HAVEN, MI 49090-7911
(269) 639-3510
(269) 639-3565
Mailing address
2929 WALKER AVE NW, GRAND RAPIDS, MI 49544-6402
(616) 791-3169
(616) 735-8532
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
5301010344
MI
3336C0003X
Community/Retail Pharmacy
Primary
5301010344
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1881010205
—
MI
Enumeration date
03/10/2014
Last updated
06/10/2014
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