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FRED MEYER STORES INC

>> Durable Medical Equipment & Medical Supplies >> Suppliers

Registrant NPI Number: 1013952548

Organizational Registrant:
Organization Name:  FRED MEYER STORES INC
Organization is not Subpart
Authorized Official:  ALLISON  MUENNICH  MANAGER OF PHARMACY LICENSING  513--76-21019

Location and contact information for practice:
13401 OLD GLENN HWY  EAGLE RIVER, AK 99577-7565 US
Tel: 907-689-4033  Fax: 907-689-4027

Contact information for business:
PO BOX 842772  BOSTON, MA 02284-2772 US
Tel: 513-762-1019  Fax: 513-762-1092

Registration Information:
NPI: 1013952548
Entity Type: Organization

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N332B00000XSuppliers
Durable Medical Equipment & Medical Supplies
N333600000XSuppliers
Pharmacy
N3336C0002XSuppliers
Pharmacy
Y3336C0003XSuppliers
Pharmacy
AKAK384

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
1021572AK05
PK199704501
PH0668AK05




HEALTH CARE JOBS AK - Page 1



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