Organization
FRED MEYER STORES INC
Active
Other names
FRED MEYER PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JESSIE WARMAN (MANAGER PHARMACY LICENSING)
(513) 762-1090
Entity
Organization
Contact information
Practice address
535 E PALMER WASILLA HWY, PALMER, AK 99645-6575
(907) 761-4233
(833) 874-1855
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
—
—
3336C0002X
Clinic Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
120080
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1021573
—
AK
01
—
1997052
PK
—
05
—
PH0671
—
AK
Enumeration date
06/18/2006
Last updated
04/22/2025
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