Organization
FRED MEYER STORES INC
Active
Other names
FRED MEYER PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ALLISON MUENNICH (MANAGER OF PHARMACY LICENSING)
(513) 762-1019
Entity
Organization
Contact information
Practice address
2801 BICKFORD AVE, SNOHOMISH, WA 98290-1734
(360) 563-3733
(360) 563-3727
Mailing address
PO BOX 842772, BOSTON, MA 02284-2772
(513) 762-1019
(513) 762-1092
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
CF00059241
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2109167
PK
—
05
—
6031512
—
WA
Enumeration date
02/28/2008
Last updated
05/16/2016
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