Organization
MEIJER GREAT LAKES LIMITED PARTNERSHIP
Active
Other names
Meijer Pharmacy #280
Organization subpart
No
Provider details
NPI number
Authorized official
JASON BEAUCH R.PH (VP OF PHARMACY MERCHANDISING)
(616) 791-3169
Entity
Organization
Contact information
Practice address
3800 VOLLMER RD, FLOSSMOOR, IL 60422-1274
(616) 791-3169
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
—
201370970A
—
IN
Enumeration date
04/11/2016
Last updated
02/25/2021
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