Organization
FRED MEYER STORES INC
Active
Other names
QFC PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MATT MINEER (INTERFACE MANAGER)
(513) 387-7074
Entity
Organization
Contact information
Practice address
1600 W DRAVUS ST, SEATTLE, WA 98119-1721
(206) 283-0366
(206) 283-2958
Mailing address
10116 NE 8TH ST, BELLEVUE, WA 98004-4148
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
CF00057697
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4930409
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
6031181
—
WA
Enumeration date
12/29/2006
Last updated
07/26/2010
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