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
2902 164TH ST SW, LYNNWOOD, WA 98087-3201
(425) 787-4933
(425) 787-4927
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
PHARCF60093686
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2121749
PK
—
05
—
6032486
—
WA
Enumeration date
09/02/2009
Last updated
07/29/2016
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