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	60006566	IN
2	3336C0003X	Community/Retail Pharmacy	60006566	IN

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	:	1629439583
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	:	5550 N KEYSTONE AVE
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46220-3458
Country	:	US
Telephone Number	:	317-610-2210
Fax Number	:	317-610-2265

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

Provider Enumeration Date	:	03/18/2016
Last Update Date	:	07/15/2016

Similar Medicare Providers

1265290407 — LANA ADILEH
Practice Location Address:

5550 N KEYSTONE AVE
INDIANAPOLIS, IN
46220-3458

Practice Phone: 317-610-2210
Practice Fax: 317-205-8065

1326927443 — ALEC JAMES BLOOMFIELD PHARMD
Practice Location Address:

5550 N KEYSTONE AVE
INDIANAPOLIS, IN
46220-3458

Practice Phone: 317-610-2210
Practice Fax: 317-205-8065

1356293054 — COMPASSIONATE CARE SOLUTIONS LLC
Practice Location Address:

2014 RALSTON AVE
INDIANAPOLIS, IN
46218-3458

Practice Phone: 317-519-6190
Practice Fax:

1861674103 — MS. DIANE LYNN CHARLES LCSW
Practice Location Address:

6621 W 12TH ST
INDIANAPOLIS, IN
46214-3458

Practice Phone: 317-243-0489
Practice Fax:

1164694345 — CARMEN MERRIWEATHER MEDICAL ASSISTANT
Practice Location Address:

7007 GRAHAM ROAD , SUITE 218
INDIANAPOLIS, IN
46220-4047

Practice Phone: 317-820-3565
Practice Fax: 317-820-3565

1548113897 — CHARLES GRAYBIEL
Practice Location Address:

2620 KESSLER BOULEVARD EAST DR STE 105
INDIANAPOLIS, IN
46220-2889

Practice Phone: 317-777-6590
Practice Fax:

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.