Organization
MEIJER INC
Active
Other names
Meijer Pharmacy #026
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
0-550 BALDWIN ST, JENISON, MI 49428-9753
(616) 667-2010
(616) 667-2065
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
5301002722
MI
3336C0003X
Community/Retail Pharmacy
Primary
5301002722
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2302482
—
MI
Enumeration date
02/06/2007
Last updated
03/19/2014
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