Organization
FRED MEYER STORES INC
Active
Other names
Fred Meyer Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
ALLISON MUENNICH (MANAGER OF PHARMACY LICENSING)
(513) 762-1019
Entity
Organization
Contact information
Practice address
30300 SW BOONES FERRY RD, WILSONVILLE, OR 97070-6889
(503) 570-3533
(503) 570-3527
Mailing address
PO BOX 842772, BOSTON, MA 02284-2772
(513) 762-1019
(513) 762-1092
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
RP0002647
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2130491
PK
—
05
—
500635706
—
OR
Enumeration date
06/10/2011
Last updated
06/28/2016
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