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
26520 MAPLE VALLEY BLACK DIAMOND RD SE, MAPLE VALLEY, WA 98038-8394
(425) 433-2333
(425) 433-2327
Mailing address
P.O. BOX 842772, BOSTON, MA 02284
(513) 762-1019
(513) 762-1092
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2133783
PK
—
Enumeration date
02/28/2012
Last updated
09/19/2025
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