Organization
FRED MEYER STORES INC
Active
Other names
FRED MEYER PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
LYSETTE SEILHAMER (MANAGER OF PHARMACY LICENSING)
(513) 762-1019
Entity
Organization
Contact information
Practice address
5050 STATE HIGHWAY 303 NE, BREMERTON, WA 98311-3629
(360) 792-2833
(360) 792-2792
Mailing address
PO BOX 2918, HUTCHINSON, KS 67504-2918
(513) 762-1090
(513) 762-1092
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
CF00003862
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2108820
PK
—
05
—
6008874
—
WA
Enumeration date
06/22/2006
Last updated
12/14/2022
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