Organization
FRED MEYER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JIM KILGUS PHARMD (PHARMACY MANAGER)
(253) 826-8433
Entity
Organization
Contact information
Practice address
1201 VALLEY AVE E, SUMNER, WA 98390-3225
(253) 826-8433
Mailing address
1201 VALLEY AVE E, SUMNER, WA 98390-3225
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
IR60290101
WA
Other
Enumeration date
05/15/2015
Last updated
05/15/2015
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