Organization Name: | MEIJER GREAT LAKES LIMITED PARTNERSHIP |
NPI Number: | 1134556277 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JASON BEAUCH (DIRECTOR OF PHARMACY MANAGED CARE) |
Mailing Address: | 3649 N. Vermilion St. Danville |
State: | IL US |
Postal Code: | 618321312 |
Phone Number: | 2176557210 |
Fax Number: | 2176557265 |
NPI Enumeration Date: | 10/03/2013 |
NPI Last Update Date: | 03/25/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | 054018334 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | IL |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |