Organization · Type 2 NPI

Meijer Stores Limited Partnership

Community/Retail Pharmacy · Manitowoc, WI

NPI number 1104458140 Active

Practice location

1818 S. Rapids Rd
Manitowoc, WI 54220-9302

Call (920) 663-3846 Map

Fax (920) 663-3865

Mailing address

2929 Walker Ave NW
Grand Rapids, MI 49544-6402

Specialties and licenses

Taxonomy	Code	License
Durable Medical Equipment & Medical Supplies	332B00000X	None listed
Community/Retail Pharmacy Primary	3336C0003X	None listed

Community/Retail Pharmacy: A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other …

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NPI record

NPI: 1104458140
Entity type: Organization (Type 2)
Issued: Feb 7, 2020
Last updated: Jul 9, 2020
Status: Active

Other names

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Meijer Pharmacy #304 · doing business as
Meijer Pharmacy #304 · doing business as

Authorized official

Raymond Burzynski
Director of Pharmacy Managed Care
(616) 249-6583

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1104458140

Meijer Stores Limited Partnership's National Provider Identifier is 1104458140, issued on Feb 7, 2020. The primary taxonomy on file is Community/Retail Pharmacy (3336C0003X), and the practice location is in Manitowoc, WI. The record was last updated on Jul 9, 2020.