FRED MEYER STORES INC. (NPI# 1629013016) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629013016 |
| Entity Type | Organization |
| Organization Name | FRED MEYER STORES INC. |
| Other Organization Name | FRED MEYER PHARMACY |
| Practice Address |
2655 Shasta Way Klamath Falls OR 97603-4455 |
| Mailing Address |
Po Box 842772 Boston MA 02284-2772 |
| Practice Telephone | 5418841780 |
| Practice Fax Number | 5418841762 |
| 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 | 333600000X | Pharmacy | Suppliers | ||
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
RP0001026CS | OR | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2077967 | 01 | |
| OR | 152918 | 05 | |
| OR | 182559 | 05 |
| Other Name | Type Code |
|---|---|
| FRED MEYER PHARMACY | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982836599 | Fred Meyer Stores Inc. | Pharmacy | 4550 42nd Ave Sw, Seattle, WA 98116-4225 | 2009-08-14 |
| 1366772451 | Fred Meyer Stores Inc. | Pharmacy | 1531 Ne 145th St, Seattle, WA 98155-7205 | 2010-01-12 |
| Street Address |
2655 SHASTA WAY |
| City | KLAMATH FALLS |
| State | OR |
| Zip Code | 97603-4455 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346218252 | Klamath Walk In Care Center Inc. | Clinic/Center | 2655 Shasta Way, Suite #7, Klamath Falls, OR 97603-4455 | 2006-03-08 |
| 1073150439 | Delia Oh | Pharmacist | 2655 Shasta Way, Klamath Falls, OR 97603-4455 | 2019-12-04 |
| 1568905776 | Anthony Lipparelli | Pharmacist | 2655 Shasta Way, Klamath Falls, OR 97603-4455 | 2016-11-21 |
| 1093160699 | Brooke E Andrews | Pharmacist | 2655 Shasta Way, Klamath Falls, OR 97603-4455 | 2016-05-02 |
| 1649682881 | Michelle Klein | Pharmacist | 2655 Shasta Way, Klamath Falls, OR 97603-4455 | 2014-05-22 |
| 1699040600 | William Lee Kennon | Pharmacist | 2655 Shasta Way, Klamath Falls, OR 97603-4455 | 2012-03-09 |
| 1760756787 | Daniel O Beardsley | Pharmacist | 2655 Shasta Way, Klamath Falls, OR 97603-4455 | 2012-03-08 |
| 1215213335 | Shasta Eyecare Associates, LLC | Optometrist | 2655 Shasta Way, Klamath Falls, OR 97603-4455 | 2011-11-03 |
| 1902073992 | Kendall A Membreno | Pharmacist | 2655 Shasta Way, Klamath Falls, OR 97603 | 2008-05-09 |
| 1700990223 | Marcia Kay Iverson-widdison | Nurse Practitioner | 2655 Shasta Way, Suite #7, Klamath Falls, OR 97603-4455 | 2006-08-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790323699 | Mike Hampson | Counselor | 3203 Vandenberg Road, Klamath Falls, OR 97603 | 2019-12-11 |
| 1356858369 | Scott Richardson | Community Based Residential Treatment Facility, Mental Illness | 3934 Rio Vista Way, Klamath Falls, OR 97603 | 2017-12-29 |
| 1720518392 | Maile Kalus | Counselor | 3647 Or-39, Klamath Falls, OR 97603 | 2017-06-15 |
| 1174067201 | Amber Wu | Audiologist | 4036 S 6th St Ste 3, Klamath Falls, OR 97603 | 2016-12-08 |
| 1568870681 | Nathan William Bailey | Dentist | 2301 Mountain View Blvd, Suite D, Klamath Falls, OR 97603 | 2014-08-01 |
| 1376987784 | Janice Marie Heiney | Denturist | 2607 Crosby Ave, Klamath Falls, OR 97603 | 2013-04-29 |
| 1083958011 | John W Cooper | Denturist | 3949 Shasta Way, Klamath Falls, OR 97603 | 2012-11-15 |
| 1205137742 | Robert Knight | Community Health Worker | 3314 Vandenburg Rd., Klamath Falls, OR 97603 | 2010-11-16 |
| 1841526431 | Tim R Jones | Counselor | 3949 South 6th St, Klamath Falls, OR 97603 | 2009-11-02 |
| 1316135833 | Ernest Thompson O'neal | Emergency Medicine | 211 Arnold Ave. Ste 15, Klamath Falls, OR 97603 | 2007-10-10 |
| Find all providers in zip 97603 | ||||
| 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 |
|---|---|---|---|---|
| 1689023780 | Klamath Health Partnership Inc | Pharmacy | 2074 S 6th St, Klamath Falls, OR 97601-3372 | 2016-06-09 |
| 1912311986 | Sky Lakes Medical Center Inc | Pharmacy | 2865 Daggett Ave, Klamath Falls, OR 97601-1106 | 2014-06-17 |
| 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 | ||||
| City | KLAMATH FALLS |
| Zip Code | 97603 |
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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.