MEDICARE: MEIJER STORES LIMITED PARTNERSHIP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	3336C0003X	Community/Retail Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1659750842
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEIJER STORES LIMITED PARTNERSHIP

Provider Business Mailing Address
First Line	:	2929 WALKER AVE NW
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49544-6402
Country	:	US
Telephone Number	:	616-791-3169
Fax Number	:	616-735-8532

Provider Business Practice Location Address
First Line	:	5600 NEW MARGARET AVE.
Second Line	:
City	:	TERRE HAUTE
State	:	IN
Zip	:	47803-9226
Country	:	US
Telephone Number	:	812-233-6310
Fax Number	:	812-233-6265

Authorized Official
Title or Position	:	DIRECTOR OF PHARMACY MANAGED CARE
Name	:	JASON BEAUCH
Credential	:	R.PH
Telephone Number	:	616-791-3169

Provider Enumeration Date	:	05/21/2015
Last Update Date	:	08/19/2015

Similar Medicare Providers

1255273264 — DANIEL & MAX, LLC
Practice Location Address:

5600 E NEW MARGARET DR
TERRE HAUTE, IN
47803-9226

Practice Phone: 812-872-2202
Practice Fax: 812-872-2111

1992189005 — USV OPTICAL INC.
Practice Location Address:

5600 E NEW MARGARET DR
TERRE HAUTE, IN
47803-9226

Practice Phone: 812-872-2202
Practice Fax:

1639040678 — MIRANDA NOELLE MILZAREK PHARMD
Practice Location Address:

5600 E NEW MARGARET DR
TERRE HAUTE, IN
47803-9226

Practice Phone: 812-233-6310
Practice Fax:

1609262377 — MICHELLE FORGEY LMHC
Practice Location Address:

2901 OHIO BLVD , SUITE 202
TERRE HAUTE, IN
47803-2239

Practice Phone: 812-232-2144
Practice Fax: 812-234-4598

1407449614 — CORA WILLIAMS RBT
Practice Location Address:

650 IN-46, TERRE HAUTE, IN 47803
TERRE HAUTE, IN
47803

Practice Phone: 317-572-5315
Practice Fax:

1134790322 — BROOKE SUDDUTH
Practice Location Address:

4701 E MARGARET DR
TERRE HAUTE, IN
47803-9303

Practice Phone: 317-334-7331
Practice Fax: 317-334-7336

Directions to “MEIJER STORES LIMITED PARTNERSHIP ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.