Organization
FRED MEYER PHARMACY
Active
Organization
FRED MEYER PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IVO MIRTCHEV PHARMD (PHARMACIST)
(702) 460-4364
Entity
Organization
Contact information
Practice address
301 E WALLACE KNEELAND BLVD, SHELTON, WA 98584-2985
(702) 460-4364
Mailing address
1530 15TH AVE UNIT 511, SEATTLE, WA 98122-3981
(702) 460-4364
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
60546634
WA
Other
Enumeration date
07/27/2015
Last updated
07/27/2015
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