FRED MEYER STORES INC (NPI# 1457396525) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457396525 |
| Entity Type | Organization |
| Organization Name | FRED MEYER STORES INC |
| Other Organization Name | FRED MEYER PHARMACY |
| Practice Address |
2497 Se Burnside Rd Gresham OR 97080-1246 |
| Mailing Address |
Po Box 842772 Boston MA 02284-2772 |
| Practice Telephone | 5036694233 |
| Practice Fax Number | 5036694238 |
| Mailing Telephone | 5137621019 |
| Mailing Fax Number | 5137621092 |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2016-06-29 |
| 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 | 333600000X | Pharmacy | Suppliers | ||
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
RP0000666CS | OR | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2077646 | 01 | |
| OR | 064063 | 05 |
| 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 |
2497 SE BURNSIDE RD |
| City | GRESHAM |
| State | OR |
| Zip Code | 97080-1246 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790186450 | Melina Wheeler | Pharmacist | 2497 Se Burnside Rd, Gresham, OR 97080-1246 | 2014-09-11 |
| 1134559487 | Kim Sato | Pharmacist | 2497 Se Burnside Rd, Gresham, OR 97080-1246 | 2013-11-24 |
| 1508292764 | Sean Harry Finn | Pharmacist | 2497 Se Burnside Rd, Gresham, OR 97080-1246 | 2013-09-19 |
| 1326384900 | Yolanda Tiu Santiago | Pharmacist | 2497 Se Burnside Rd, Gresham, OR 97080-1246 | 2012-12-29 |
| 1891052700 | Amanda Ruth Norman | Pharmacist | 2497 Se Burnside Rd, Gresham, OR 97080-1246 | 2012-04-16 |
| 1467725432 | Gabriel Tucker Bertell | Pharmacist | 2497 Se Burnside Rd, Gresham, OR 97080-1246 | 2012-02-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528428554 | Jeffrey Henry Lucero | Social Worker | 4687 Se 1st Terrace, Gresham, OR 97080 | 2016-03-03 |
| 1124371059 | Nickole Turner | Massage Therapist | 2831 Se Palmquist Rd #157, Gresham, OR 97080 | 2012-10-16 |
| 1992061048 | Russell A Wendt | Pharmacist | 2497 Ne Roberts Ave, Gresham, OR 97080 | 2012-04-03 |
| 1821385584 | Angela West | Counselor | 320 Sw 6th Ave., Gresham, OR 97080 | 2011-07-01 |
| 1043543572 | Natalie Dawn Wilson | Behavioral Analyst | 97 Sw Riverview Place, Gresham, OR 97080 | 2009-09-16 |
| 1427205442 | Maria G Jolley | Dental Hygienist | 1267 Se Stapleton Loop, Gresham, OR 97080 | 2008-08-21 |
| 1073776738 | Sabrina Joye Hindman | Marriage & Family Therapist | 6370 Se 26th St, Gresham, OR 97080 | 2008-07-03 |
| 1669676193 | Kimberly Sabin | Nurse Practitioner | 2222 E Powell Blvd, Gresham, OR 97080 | 2007-06-11 |
| 1932223880 | Julie Elizabeth Croshaw | Pharmacist | 2444 E Powell Blvd, Gresham, OR 97080 | 2007-03-18 |
| 1508903261 | Lonetta Elise Davis | Adult Companion | 349 Se Plamblad, Gresham, OR 97080 | 2007-01-31 |
| Find all providers in zip 97080 | ||||
| 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 |
|---|---|---|---|---|
| 1588741458 | Assured Pharmacy Gresham Inc | Pharmacy | 831 Nw Counsil Dr, Ste 115, Gresham, OR 97030 | 2006-10-31 |
| 1992712822 | Walgreen Co | Pharmacy | 1950 Ne Burnside Rd, Gresham, OR 97030-7949 | 2006-08-02 |
| 1740524453 | Walmart Inc. | Pharmacy | 2444 E Powell Blvd, Gresham, OR 97080-1311 | 2012-11-19 |
| 1992725477 | Legacy Mount Hood Medical Center | Pharmacy | 24800 Se Stark St, Gresham, OR 97030-3378 | 2006-07-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972104354 | Jrrx LLC | Pharmacy | 621 Hickory St Nw, Albany, OR 97321-1754 | 2020-11-03 |
| 1346850641 | Credena Health LLC | Pharmacy | 1510 Division St Ste 110, Oregon City, OR 97045-1572 | 2020-08-03 |
| 1235747775 | Cordant Pharmacy Oregon, LLC | Pharmacy | 6135 Ne 80th Ave Ste A2, Portland, OR 97218-4033 | 2020-07-21 |
| 1578184909 | Capsule Portland LLC | Pharmacy | 416 Nw 12th Ave, Portland, OR 97209-2907 | 2020-04-27 |
| 1588291645 | Avita Drugs Oregon, LLC | Pharmacy | 2236 Se Belmont St Ste B, Portland, OR 97214-2817 | 2020-03-26 |
| 1467090183 | Mosaic Medical | Pharmacy | 375 Nw Beaver St Ste 103, Prineville, OR 97754-1802 | 2019-12-12 |
| 1598302119 | Beacon Health Care Solutions Incorporated | Pharmacy | 2790 Broadway Ave, North Bend, OR 97459-2216 | 2019-12-02 |
| 1508337577 | Oregon Health & Science University | Pharmacy | 3303 Sw Bond Ave Rm 1090, Portland, OR 97239-4501 | 2018-12-17 |
| 1588131296 | Home Town Drugs of Cottage Grove, Inc. | Pharmacy | 1205 Hwy 99 North, Cottage Grove, OR 97424 | 2018-10-31 |
| 1659857480 | Avalina Pharmacy Inc | Pharmacy | 3507 Commercial St Se, Salem, OR 97302 | 2018-07-16 |
| Find all providers with the same taxonomy | ||||
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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.