Organization
MEIJER GREAT LAKES LIMITED PARTNERSHIP
Active
Other names
Meijer Pharmacy #182
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
855 S RANDALL RD, ST CHARLES, IL 60174-1570
(630) 762-7210
(630) 762-7265
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
054014352
IL
3336C0003X
Community/Retail Pharmacy
Primary
054014352
IL
Other
Enumeration date
01/10/2012
Last updated
02/25/2021
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