Organization
FRED MEYER STORES INC
Active
Other names
FRED MEYER Pharmacy #372
Organization subpart
No
Provider details
NPI number
Authorized official
ALLISON MUENNICH (MANAGER OF PHARMACY LICENSING)
(513) 762-1019
Entity
Organization
Contact information
Practice address
1215 W 6TH ST, THE DALLES, OR 97058-3515
(541) 296-1748
(541) 296-1756
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
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
RP0000771CS
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1044021
—
WA
05
—
182553
—
OR
01
—
2077803
PK
—
05
—
6117402
—
OR
Enumeration date
06/23/2006
Last updated
09/19/2025
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