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General NPI Number Information
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NPI Number | 1023813094
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Entity Type | Organization
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Legal Business Name | MEIJER STORES LIMITED PARTNERSHIP
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Dates
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Enumeration Date | 02/14/2025
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Last Update Date | 07/18/2025
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Provider Practice Location Address
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Address Line | 5155 WILSON MILLS RD
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City | RICHMOND HEIGHTS
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State | OH
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Zip | 44143
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Country | US
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Telephone | 216-428-0810
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Fax | 216-428-0185
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Provider Business Mailing Address
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Address Line | 2929 WALKER AVE NW
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City | GRAND RAPIDS
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State | MI
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Zip | 49544-9428
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Country | US
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Telephone | 616-791-3485
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF MANAGED CARE
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Name | KRYSTAL SHEERER
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Credential |
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Telephone | 616-791-3485
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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