Organization
FRED MEYER STORES INC
Active
Other names
QFC PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MATT MINEER (INTERFACE MANAGER)
(513) 387-7074
Entity
Organization
Contact information
Practice address
8532 15TH AVE NW, SEATTLE, WA 98117-3605
(206) 297-8688
(206) 297-8760
Mailing address
10116 NE 8TH ST, BELLEVUE, WA 98004-4148
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
CF56657
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4927882
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
6023220
—
WA
Enumeration date
07/13/2006
Last updated
07/10/2009
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