Provider Demographics
NPI:1992831978
Name:MEIJER INC
Entity Type:Organization
Organization Name:MEIJER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER PHARAMCY THIRD PARTY PROG
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:BEAUCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:616-791-3346
Mailing Address - Street 1:2929 WALKER AVE NW
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49544-9424
Mailing Address - Country:US
Mailing Address - Phone:616-791-3346
Mailing Address - Fax:616-735-8532
Practice Address - Street 1:2929 WALKER AVE NW
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49544-9424
Practice Address - Country:US
Practice Address - Phone:616-791-3346
Practice Address - Fax:616-735-8532
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies