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NPI Code Detail

MEDICARE: MEIJER STORES LIMITED PARTNERSHIP

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
1332B00000XDurable Medical Equipment & Medical Supplies
23336C0003XCommunity/Retail Pharmacy

General Provider Information

NPI Number : 1023813094
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 : 49544-9428
Country : US
Telephone Number : 616-791-3485
Fax Number :
Provider Business Practice Location Address
First Line : 5155 WILSON MILLS RD
Second Line :
City : RICHMOND HEIGHTS
State : OH
Zip : 44143
Country : US
Telephone Number : 216-428-0810
Fax Number : 216-428-0185
Authorized Official
Title or Position : DIRECTOR OF MANAGED CARE
Name : KRYSTAL SHEERER
Credential :
Telephone Number : 616-791-3485
Provider Enumeration Date : 02/14/2025
Last Update Date : 07/18/2025

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Directions to “MEIJER STORES LIMITED PARTNERSHIP ” Practice Location

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