FRED MEYER PHARMACY (NPI# 1245781574) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245781574 |
| Entity Type | Organization |
| Organization Name | FRED MEYER PHARMACY |
| Practice Address |
705 Blue Lakes Blvd N Twin Falls ID 83301-4007 |
| Practice Telephone | 1208736537 |
| Mailing Telephone | 1208736537 |
| Enumeration Date | 2016-10-21 |
| Last Update Date | 2016-10-21 |
| Authorized Official Name | DR. JOANNE LOUISE KREUZER (REGISTERED PHARMACIST) |
| Authorized Official Telephone | 12087365373 |
| Authorized Official Credential | PHARM. D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QC1500X |
Clinic/Center Specialization: Community Health |
P5593 | ID | Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891030300 | Fred Meyer Pharmacy | Clinic/Center | 4505 South 19th, Tacoma, WA 98405 | 2012-12-10 |
| 1366827834 | Fred Meyer Pharmacy | Pharmacy | 301 E Wallace Kneeland Blvd, Shelton, WA 98584-2985 | 2015-07-27 |
| 1619385259 | Fred Meyer Pharmacy | Clinical Medical Laboratory | 3030 Ne Weidler St, Portland, OR 97232-1851 | 2014-07-28 |
| 1447684964 | Fred Meyer Pharmacy | Pharmacist | 944 Sw 9th St, Redmond, OR 97756 | 2013-09-03 |
| Street Address |
705 BLUE LAKES BLVD N |
| City | TWIN FALLS |
| State | ID |
| Zip Code | 83301-4007 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043256951 | Fred Meyer Stores Inc | Durable Medical Equipment & Medical Supplies | 705 Blue Lakes Blvd N, Twin Falls, ID 83301-4007 | 2006-06-20 |
| 1093320624 | Trell James Dowd | Pharmacist | 705 Blue Lakes Blvd N, Twin Falls, ID 83301 | 2020-09-10 |
| 1134467343 | John Robert Deboard | Pharmacist | 705 Blue Lakes Blvd N, Twin Falls, ID 83301-4007 | 2013-01-22 |
| 1316211873 | Eric Vern Herzog | Pharmacist | 705 Blue Lakes Blvd N, Twin Falls, ID 83301-4007 | 2012-03-01 |
| 1558660431 | Anthony James Vaughn | Pharmacist | 705 Blue Lakes Blvd N, Twin Falls, ID 83301-4007 | 2011-03-18 |
| 1578612131 | Dale L Miles | Optometrist | 705 Blue Lakes Blvd N, Suite B, Twin Falls, ID 83301-4007 | 2007-01-10 |
| 1316096993 | Chris Harmon LLC Dba Eye Valu Vision Center | Eyewear Supplier (Equipment, not the service) | 705 Blue Lakes Blvd N, Suite B, Twin Falls, ID 83301-4007 | 2007-01-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023645918 | Matthew Anderson | Pharmacist | Dick's Pharmacy, 526 K Shoup Ave W, Twin Falls, ID 83301 | 2020-03-23 |
| 1780146316 | Frontier Pediatric Partners, Pllc | Pediatrics | 1502 Locust Street N #700, Twin Falls, ID 83301 | 2019-04-02 |
| 1972073377 | Wood River Acupuncture | Acupuncturist | 1625 Addison Ave East, Twin Falls, ID 83301 | 2018-11-28 |
| 1235629874 | Lonnie Paul | Counselor | 1092 Eastland Dr N Ste A, Twin Falls, ID 83301 | 2018-05-17 |
| 1679060966 | Christina Jirapha Thongdee | Social Worker | 625 Poleline Road West, Suite 2a, Twin Falls, ID 83301 | 2018-04-23 |
| 1437658499 | Tyrel Kevin Ward | Chiropractor | 2167 Village Park Ave., Suite 100, Twin Falls, ID 83301 | 2018-02-06 |
| 1851836381 | Tanabell Health Services, Inc | Skilled Nursing Facility | 1134 Cheney Drive West, Twin Falls, ID 83301 | 2016-12-19 |
| 1578005195 | Matthew Carter | Physical Therapist | 1053 Eastland Drive, Twin Falls, ID 83301 | 2016-11-14 |
| 1790227783 | Murvat Usmanova | Nurse Practitioner | 775 Pole Line Road W, Suite 203, Twin Falls, ID 83301 | 2016-11-08 |
| 1265894687 | Shawna Fultz | Social Worker | 1201 Fall Ave East Suite C, Twin Falls, ID 83301 | 2016-03-24 |
| Find all providers in zip 83301 | ||||
| Taxonomy Code | 261QC1500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Community Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063643690 | Bonner Partners In Care Clinic | Clinic/Center | 1020 Michigan St, Sandpoint, ID 83864-1788 | 2009-07-30 |
| City | TWIN FALLS |
| Zip Code | 83301 |
Please comment or provide details below to improve the information on FRED MEYER PHARMACY.
| 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.