| NPI | 1174051023 |
|---|---|
| Doing Business As | FRED MEYER PHARMACY #069 |
| Entity Type | Organization |
| Authorized Contact | KARLA STONE Pharmacy Credentialing Manager 513-698-1878 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: WA PHAR.CF.00057554) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2017-05-23 |
| Last Update Date | 2018-07-19 |