MEDICARE: MEIJER, INC.

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

General Provider Information

NPI Number	:	1508717109
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEIJER, INC.

Provider Business Mailing Address
First Line	:	2929 WALKER AVE NW
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49544-6402
Country	:	US
Telephone Number	:	616-791-3485
Fax Number	:

Provider Business Practice Location Address
First Line	:	1495 N ROCHESTER RD
Second Line	:
City	:	ROCHESTER HILLS
State	:	MI
Zip	:	48307-1122
Country	:	US
Telephone Number	:	248-218-4330
Fax Number	:	248-218-4365

Authorized Official
Title or Position	:	DIRECTOR PAYER RELATIONS/WELLNESS
Name	:	LUKE GUMPER
Credential	:
Telephone Number	:	616-791-5730

Provider Enumeration Date	:	02/09/2026
Last Update Date	:	02/09/2026

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Directions to “MEIJER, INC. ” Practice Location

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