Organization
FRED MEYER STORES INC
Active
Other names
QFC PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JESSIE WARMAN (MANAGER OF PHARMACY LICENSING)
(513) 762-1019
Entity
Organization
Contact information
Practice address
2636 BELLEVUE WAY NE, BELLEVUE, WA 98004
(425) 576-9222
(425) 576-9199
Mailing address
PO BOX 842772, BOSTON, MA 02284-2772
(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
CF57119
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2107391
PK
—
05
—
6025431
—
WA
Enumeration date
07/13/2006
Last updated
09/04/2018
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