Meijer Great Lakes Limited Partnership

NPI #1013287853 in Springfield, Illinois

Provider Information

NPI Number
1013287853
Entity Type
Organization
Organization Name
Meijer Great Lakes Limited Partnership
Primary Specialty
Pharmacy - Community/Retail Pharmacy
Enumeration Date
Jan 11, 2012
Last Updated
Mar 24, 2014

Practice Location

Address
4200 CONESTOGA DR
ZIP Code
62711-7962
Phone
(217) 547-2410

Authorized Official

Name
JASON BEAUCH, RPH
Title
DIRECTOR OF PHARMACY MANAGED CARE
Phone
(616) 791-3169

Specialties & Taxonomy Codes

Specialty
Durable Medical Equipment & Medical Supplies
Pharmacy - Community/Retail PharmacyCommunity/Retail Pharmacy

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