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FRED MEYER STORES INC

Clinic Pharmacy >> Pharmacy >> Suppliers

Registrant NPI Number: 1487699914

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:
930 OLD STEESE HWY  FAIRBANKS, AK 99701-3167 US
Tel: 907-459-4233  Fax: 907-459-4227

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

Registration Information:
NPI: 1487699914
Entity Type: Organization

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N3336C0002XSuppliers
Pharmacy
Clinic Pharmacy
N332B00000XSuppliers
Durable Medical Equipment & Medical Supplies
N333600000XSuppliers
Pharmacy
Y3336C0003XSuppliers
Pharmacy
AKAK415

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
1021787AK05
PK199687501
PH3798AK05




HEALTH CARE JOBS AK - Page 1



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