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
17411 SE 272ND ST, COVINGTON, WA 98042-5311
(253) 631-1200
(253) 631-7147
Mailing address
10116 NE 8TH ST, BELLEVUE, WA 98004-4148
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
CF59062
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4932352
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
6030498
—
WA
Enumeration date
05/01/2007
Last updated
07/14/2009
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