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
7701 DEBARR RD, ANCHORAGE, AK 99504-1894
(907) 269-1733
(907) 269-1727
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
—
—
3336C0002X
Clinic Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
AK387
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1021515
—
AK
05
—
1021544
—
AK
01
—
1996855
PK
—
05
—
PH0321
—
AK
Enumeration date
06/22/2006
Last updated
08/19/2020
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