| NPI | 1295822443 |
|---|---|
| Doing Business As | MEIJER PHARMACY #104 |
| Entity Type | Organization |
| Authorized Contact | JASON BEAUCH Director Of Pharmacy Managed Care 616-791-3169 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: OH 02-687900) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: OH 02687900) |
| Enumeration Date | 2006-10-09 |
| Last Update Date | 2014-03-17 |