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Organization

MEIJER STORES LIMITED PARTNERSHIP

Active
Other names
Meijer Pharmacy #110
Organization subpart
No

Provider details

NPI number
Authorized official
JASON BEAUCH R.PH (DIRECTOR OF PHARMACY MANAGED CARE)
(616) 791-3169
Entity
Organization

Contact information

Practice address
3298 ELIDA RD, LIMA, OH 45805-1220
(419) 331-6410
(419) 331-6463
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
02721600
OH
3336C0003X
Community/Retail Pharmacy
Primary
02721600
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0907808
OH
Enumeration date
12/22/2006
Last updated
03/17/2014
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