MEDICARE: MEIJER GREAT LAKES 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

General Provider Information

NPI Number	:	1891159455
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEIJER GREAT LAKES 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	:	616-793-5853

Provider Business Practice Location Address
First Line	:	750 E ROLLINS RD
Second Line	:
City	:	ROUND LAKE BEACH
State	:	IL
Zip	:	60073-1340
Country	:	US
Telephone Number	:	847-210-0810
Fax Number	:	847-201-0765

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

Provider Enumeration Date	:	04/11/2016
Last Update Date	:	02/25/2021

Similar Medicare Providers

1144189820 — SHOPTIKAL LLC
Practice Location Address:

718 E ROLLINS RD # 9
ROUND LAKE BEACH, IL
60073-1340

Practice Phone: 920-429-2211
Practice Fax:

1285699033 — OPEN ADVANCED MRI OF ROUND LAKE, LLC
Practice Location Address:

720 E ROLLINS RD
ROUND LAKE BEACH, IL
60073-1340

Practice Phone: 847-546-3600
Practice Fax: 847-546-3633

1730353608 — ROLLINS CHIROPRACTIC
Practice Location Address:

702 E ROLLINS RD
ROUND LAKE BEACH, IL
60073-1340

Practice Phone: 847-740-1100
Practice Fax: 847-740-1100

1659725679 — USV OPTICAL INC.
Practice Location Address:

750 E ROLLINS RD
ROUND LAKE BEACH, IL
60073-1340

Practice Phone: 847-740-5178
Practice Fax: 847-740-5274

1225563380 — ROUND LAKE MEDICAL IMAGING INC
Practice Location Address:

720 E ROLLINS RD
ROUND LAKE BEACH, IL
60073-1340

Practice Phone: 847-546-3600
Practice Fax:

1386200319 — ROUND LAKE MRI, INC
Practice Location Address:

720 E ROLLINS RD
ROUND LAKE BEACH, IL
60073-1340

Practice Phone: 847-546-3600
Practice Fax: 847-546-3633

Directions to “MEIJER GREAT LAKES 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.