FRED MEYER STORES INC (NPI# 1003842733) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1003842733 |
Entity Type | Organization |
Organization Name | FRED MEYER STORES INC |
Other Organization Name | FRED MEYER PHARMACY |
Practice Address |
2424 Crater Lake Hwy Medford OR 97504-4181 |
Mailing Address |
P.o. Box 842772 Boston MA 02284 |
Practice Telephone | 5417794153 |
Practice Fax Number | 5417342127 |
Mailing Telephone | 5137621019 |
Mailing Fax Number | 5137621092 |
Enumeration Date | 2006-06-24 |
Last Update Date | 2018-07-19 |
Authorized Official Name | ALLISON MUENNICH (MANAGER OF PHARMACY LICENSING) |
Authorized Official Telephone | 5137621019 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
N | 333600000X | Pharmacy | Suppliers | ||
Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
RP0000863CS | OR | Suppliers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
OR | 263848 | 05 | |
PK | 2077861 | 01 |
Other Name | Type Code |
---|---|
FRED MEYER PHARMACY | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1942746672 | Fred Meyer Stores Inc | Durable Medical Equipment & Medical Supplies | 5502 Point Fosdick Dr Nw, Gig Harbor, WA 98335-1725 | 2017-01-19 |
1154695849 | Fred Meyer Stores Inc | Durable Medical Equipment & Medical Supplies | 26520 Maple Valley Black Diamond Rd Se, Maple Valley, WA 98038-8394 | 2012-02-28 |
1053580548 | Fred Meyer Stores Inc | Pharmacy | 2801 Bickford Ave, Snohomish, WA 98290-1734 | 2008-02-28 |
1497976930 | Fred Meyer Stores Inc | Pharmacy | 500 Mercer St, Seattle, WA 98109-4654 | 2007-05-01 |
1740401272 | Fred Meyer Stores Inc | Pharmacy | 17411 Se 272nd St, Covington, WA 98042-5311 | 2007-05-01 |
1689730046 | Fred Meyer Stores Inc | Pharmacy | 1600 W Dravus St, Seattle, WA 98119-1721 | 2006-12-29 |
1295809598 | Fred Meyer Stores Inc | Pharmacy | 23475 Ne Novelty Hill Rd, Redmond, WA 98053-5501 | 2006-11-20 |
1730253261 | Fred Meyer Stores Inc | Pharmacy | 27008 92nd Ave Nw, Stanwood, WA 98292-5343 | 2006-11-17 |
1194899625 | Fred Meyer Stores Inc | Durable Medical Equipment & Medical Supplies | 9999 Holman Rd Nw, Seattle, WA 98117-2041 | 2006-11-17 |
1912071440 | Fred Meyer Stores Inc | Durable Medical Equipment & Medical Supplies | 700 Sleater Kinney Rd Ne, Lacey, WA 98503 | 2006-11-17 |
Street Address |
2424 CRATER LAKE HWY |
City | MEDFORD |
State | OR |
Zip Code | 97504-4181 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1508804550 | National Vision, Inc. | Eyewear Supplier (Equipment, not the service) | 2424 Crater Lake Hwy, Medford, OR 97504-4181 | 2006-06-03 |
1477162691 | Julian Thomas Sonnenburg | Pharmacist | 2424 Crater Lake Hwy, Medford, OR 97504-4181 | 2020-07-23 |
1164064515 | Trey Austin Davenhill | Pharmacist | 2424 Crater Lake Hwy, Medford, OR 97504-4181 | 2019-10-16 |
1336659382 | Alexander Thomas Roe | Pharmacist | 2424 Crater Lake Hwy, Medford, OR 97504-4181 | 2017-10-04 |
1134555691 | Fatima Aboozar | Pharmacist | 2424 Crater Lake Hwy, Medford, OR 97504-4181 | 2013-09-16 |
1992144109 | Mark Lee Shuey | Pharmacist | 2424 Crater Lake Hwy, Medford, OR 97504-4181 | 2013-06-20 |
1922447119 | Kenneth F Hahn | Pharmacist | 2424 Crater Lake Hwy, Medford, OR 97504-4181 | 2013-06-20 |
1811262819 | Roberta Lee Hupp | Pharmacist | 2424 Crater Lake Hwy, Medford, OR 97504-4181 | 2012-03-09 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1225673833 | Lydia D Sneed | Behavioral Analyst | 3707 Citation Way, Suite 102, Medford, OR 97504 | 2019-11-07 |
1114577368 | Heather Ashley Fronek | Nurse Practitioner | 2825 E. Barnett Rd., Medford, OR 97504 | 2019-09-18 |
1255809109 | Justin Blasdel | Technician, Health Information | 3250 Lone Pine Rd, Medford, OR 97504 | 2018-11-08 |
1396220133 | Aimee K Michel | Massage Therapist | 3550 National Dr., Medford, OR 97504 | 2018-09-27 |
1437646908 | Zola Dental Medford LLC | Dentist | 922 E Main, Medford, OR 97504 | 2018-04-19 |
1376068015 | Megan Leggett | Counselor | 777 Murphy Road, Medford, OR 97504 | 2017-08-03 |
1023547536 | Joshua Morgan Rice | Dentist | 1117 E Main St Ste 1, Medford, OR 97504 | 2017-06-08 |
1427580232 | Paul James Dean | Counselor | 1175 Main St Ste 1c, Medford, OR 97504 | 2017-03-30 |
1811443542 | Taya Adams | Doula | 1201 Progress Dr #90, Medford, OR 97504 | 2016-09-01 |
1174076228 | Avalon Health Care - Hearthstone, LLC | Skilled Nursing Facility | 2091 E. Barnett Road, Medford, OR 97504 | 2016-07-25 |
Find all providers in zip 97504 |
Taxonomy Code | 3336C0003X |
Grouping | Suppliers |
Classification | Pharmacy |
Specialization | Community/Retail Pharmacy |
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1083160147 | Safeway | Pharmacy | 2001 Table Rock Rd, Apt 28, Medford, OR 97501-1483 | 2016-08-29 |
1902168289 | Medford Family Pharmacy LLC | Pharmacy | 103 Old Marlton Pike Ste 123, Medford, NJ 08055-8772 | 2012-06-12 |
1205043387 | Walgreen Co | Pharmacy | 210 E Barnett Rd, Medford, OR 97501-7928 | 2007-05-17 |
1285717520 | New Jersey Cvs Pharmacy LLC | Pharmacy | 137 Route 70, Medford, NJ 08055-2378 | 2006-10-23 |
1598864944 | Cvs Pharmacy Inc | Pharmacy | 590 Fellsway, Medford, MA 02155-4925 | 2006-09-22 |
1124127576 | Cvs Pharmacy Inc | Pharmacy | 55 Riverside Ave, Medford, MA 02155-4605 | 2006-09-22 |
1780781625 | Medford Pharmacy Group LLC | Pharmacy | 2355 W Main St, Medford, OR 97501 | 2006-09-20 |
1669576427 | Cvs Albany LLC | Pharmacy | 1565 Route 112, Medford, NY 11763-3647 | 2006-09-12 |
1548375322 | Medford Shoprite, Inc. | Pharmacy | 208 Route 70, Medford, NJ 08055-9522 | 2006-08-20 |
1518998079 | Walgreen Co | Pharmacy | 49 Station Lndg, Medford, MA 02155-5192 | 2006-07-05 |
Find all providers in MEDFORD |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.