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FRED MEYER STORES INC NPI 1922043454


NPI Information

NPI: 1922043454
Provider Name: FRED MEYER STORES INC

Doing Business As: FRED MEYER PHARMACY

Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

CLIA Number: 02D1096635

Address:
535 E PALMER WASILLA HWY
PALMER, AK
ZIP 99645
Phone: (907) 761-4233
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FRED MEYER STORES INC is a community/retail pharmacy pharmacy in Palmer, 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 1922043454. 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:

535 E PALMER WASILLA HWY
PALMER, AK
ZIP 99645-575
Phone: (907) 761-4233
Fax: (907) 761-4227

The provider's authorized official is Jessie Warman .
The authorized official title is Manager Pharmacy Licensing and has the following contact phone number (513) 762-1090.

The CLIA number assigned to this NPI record is 02D1096635 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/18/2006 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
1332B00000XDurable Medical Equipment & Medical SuppliesNo
2333600000XPharmacyNo
33336C0002XPharmacyClinic PharmacyNo
43336C0003XPharmacyCommunity/Retail Pharmacy120080ALASKAYes

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
1PH0671MEDICAIDALASKA
21997052OTHERPK
31021573MEDICAIDALASKA

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: 4/28/2024

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.