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FRED MEYER STORES INC NPI 1508802059


NPI Information

NPI: 1508802059
Provider Name: FRED MEYER STORES INC

Doing Business As: FRED MEYER PHARMACY

Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

CLIA Number: 02D1013247

Address:
3755 AIRPORT WAY
FAIRBANKS, AK
ZIP 99709
Phone: (907) 474-1433
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FRED MEYER STORES INC is a community/retail pharmacy pharmacy in Fairbanks, AK. The provider is 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. FRED MEYER STORES INC NPI is 1508802059. The provider is registered as an organization entity type.
The provider Is Doing Business As Fred Meyer Pharmacy.

The provider's business location address is:

3755 AIRPORT WAY
FAIRBANKS, AK
ZIP 99709-610
Phone: (907) 474-1433
Fax: (907) 474-1447

The provider's authorized official is Allison Muennich .
The authorized official title is Manager Of Pharmacy Licensing and has the following contact phone number (513) 762-1019.

The CLIA number assigned to this NPI record is 02D1013247 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/22/2006 and was last updated on 10/14/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1333600000XPharmacyNo
23336C0002XPharmacyClinic PharmacyNo
3332B00000XDurable Medical Equipment & Medical SuppliesNo
43336C0003XPharmacyCommunity/Retail PharmacyAK391ALASKAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11021555MEDICAIDALASKA
2MS0712MEDICAIDALASKA
31996601OTHERPK
4PH0712MEDICAIDALASKA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.