Organization
FRED MEYER STORES INC
Active
Organization
FRED MEYER STORES INC
Active
Other names
QFC PHARMACY #70500894
Organization subpart
No
Provider details
NPI number
Authorized official
JESSIE WARMAN (MANAGER OF PHARMACY LICENSING)
(513) 762-1090
Entity
Organization
Contact information
Practice address
425 URBAN PLZ STE 100, KIRKLAND, WA 98033-5371
(425) 822-4123
(425) 803-3292
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
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
CF57008
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2107328
PK
—
05
—
6031199
—
WA
Enumeration date
07/13/2006
Last updated
07/30/2019
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