Organization
THE BARTELL DRUG COMPANY
Active
Other names
Bartell Drugs # 04
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PETER KOO (SR VP OF PHARMACY)
(206) 763-2626
Entity
Organization
Contact information
Practice address
5605 22ND AVE NW, SEATTLE, WA 98107
(206) 783-3051
(206) 784-9272
Mailing address
4025 DELRIDGE WAY SW, #400, SEATTLE, WA 98106
(206) 763-2626
(206) 767-1397
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
CF
WA
3336C0003X
Community/Retail Pharmacy
CF00000051
WA
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4906321
NCPDP
WA
01
—
6032403
MEDICAID DME
WA
05
—
6032403
—
WA
01
—
P00070933
PART B RAILROAD
WA
Enumeration date
08/24/2006
Last updated
01/23/2014
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