Organization
FRED MEYER STORES INC
Active
Other names
Fred Meyer Pharmacy #685
Organization subpart
No
Provider details
NPI number
Authorized official
ALLISON MUENNICH (MANAGER OF PHARMACY LICENSING)
(513) 762-1019
Entity
Organization
Contact information
Practice address
1400 W CHINDEN BLVD, MERIDIAN, ID 83646-5328
(208) 893-6033
(208) 893-6027
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
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1508132069
—
ID
01
—
2134485
PK
—
Enumeration date
03/29/2012
Last updated
04/22/2025
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