FRED MEYER STORES INC (NPI# 1568407096) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568407096 |
| Entity Type | Organization |
| Organization Name | FRED MEYER STORES INC |
| Other Organization Name | FRED MEYER PHARMACY |
| Practice Address |
2855 Broadway St Ne Salem OR 97303-6502 |
| Mailing Address |
Po Box 842772 Boston MA 02284-2772 |
| Practice Telephone | 5033912433 |
| Practice Fax Number | 5033912427 |
| Mailing Telephone | 5137621019 |
| Mailing Fax Number | 5137621092 |
| Enumeration Date | 2006-06-18 |
| Last Update Date | 2016-05-16 |
| 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 |
RP0000073CS | OR | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 064295 | 05 | |
| PK | 2077451 | 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 |
2855 BROADWAY ST NE |
| City | SALEM |
| State | OR |
| Zip Code | 97303-6502 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457801227 | Julie Lynne Miller Van Otterloo | Pharmacist | 2855 Broadway St Ne, Salem, OR 97303-6502 | 2016-10-05 |
| 1568865111 | Megan Pokorny | Pharmacist | 2855 Broadway St Ne, Salem, OR 97305 | 2014-09-26 |
| 1245595891 | Edward Lee Holland | Pharmacist | 2855 Broadway St Ne, Salem, OR 97303-6502 | 2012-07-10 |
| 1548535156 | Linda Sullivan | Pharmacist | 2855 Broadway St Ne, Salem, OR 97303-6502 | 2012-03-14 |
| 1710251210 | Kyle R Elwood | Pharmacist | 2855 Broadway St Ne, Salem, OR 97303-6502 | 2012-03-01 |
| 1144594052 | Chad S Miller | Pharmacist | 2855 Broadway St Ne, Salem, OR 97303-6502 | 2012-02-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649750175 | Kristin Marie Barz | Behavioral Analyst | 4690 12th Ave Ne, Keizer, OR 97303 | 2018-08-15 |
| 1003359605 | Angela Rose Richard | Community Health Worker | 3410 Cherry Avenue Ne, Keizer, OR 97303 | 2016-11-30 |
| 1881146629 | Alma Denise Vera | Dental Hygienist | 5825 Shoreview Lane Ste C, Keizer, OR 97303 | 2016-10-27 |
| 1679919849 | Ramya Shyamala Kamath | Dentist | 4817 River Rd N, Keizer, OR 97303 | 2013-05-15 |
| 1356682041 | Teresa M Treinen | Physical Therapist | 190 Sandy Drive N, Keizer, OR 97303 | 2013-03-06 |
| 1598001844 | Eagle Eye Vision Care LLC | Optometrist | 4048 River Road North, Keizer, OR 97303 | 2012-12-13 |
| 1245590553 | Thora Jane Stacy | Dental Assistant | 2300 N.e. Lacncaster Dr., Salem, OR 97303 | 2012-05-21 |
| 1295028850 | Rodger Nordskog Magnuson | Pharmacist | 5452 River Road N., Keizer, OR 97303 | 2011-05-16 |
| 1326299843 | Douglas Scott Hamblin | Pediatrics | 5685 Inland Shores Way, Keizer, OR 97303 | 2008-10-02 |
| 1982870382 | Debra Kaye Lynch | Podiatrist | 4905 River Road N, Keizer, OR 97303 | 2008-05-06 |
| Find all providers in zip 97303 | ||||
| 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] |
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| 1659857480 | Avalina Pharmacy Inc | Pharmacy | 3507 Commercial St Se, Salem, OR 97302 | 2018-07-16 |
| 1386090793 | Good Living Inc | Pharmacy | 1201 N Jim Day Rd Ste B, Suite B, Salem, IN 47167-7219 | 2016-05-05 |
| 1760859367 | Quisenberry Health System Pharmacy, LLC | Pharmacy | 148 Liberty St Se, Salem, OR 97301-3506 | 2015-08-31 |
| 1649306531 | Benignity LLC Dba Fort Lewis Pharmacy | Pharmacy | 2246 West Main St, Salem, VA 24153 | 2007-02-26 |
| 1316047749 | Cvs Pharmacy Inc | Pharmacy | 272 Highland Ave, Salem, MA 01970-1832 | 2006-09-25 |
| 1366542318 | Guffeys Pharmacy Inc | Pharmacy | 172 Hwy 62 E, Suite 2, Salem, AR 72576-0155 | 2006-09-22 |
| 1487753836 | Cvs Pharmacy Inc | Pharmacy | 200 Essex St, Salem, MA 01970-3705 | 2006-09-22 |
| 1730288184 | Cvs Pharmacy Inc | Pharmacy | 426b Essex St, Salem, MA 01970-3152 | 2006-09-22 |
| 1982707618 | Virginia Cvs Pharmacy, L.L.C. | Pharmacy | 179 Electric Rd, Salem, VA 24153-4432 | 2006-09-07 |
| Find all providers in SALEM | ||||
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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.