FRED MEYER STORES INC (NPI# 1740225275) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740225275 |
| Entity Type | Organization |
| Organization Name | FRED MEYER STORES INC |
| Other Organization Name | FRED MEYER PHARMACY |
| Practice Address |
800 Yellowstone Ave Pocatello ID 83201-4433 |
| Mailing Address |
Po Box 842772 Boston MA 02284-2772 |
| Practice Telephone | 2082394033 |
| Practice Fax Number | 2082394027 |
| Mailing Telephone | 5137621019 |
| Mailing Fax Number | 5137621092 |
| Enumeration Date | 2006-06-18 |
| Last Update Date | 2016-08-12 |
| Authorized Official Name | ALLISON MUENNICH (MANAGER OF PHARMACY LICENSING) |
| Authorized Official Telephone | 5137621019 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
1292RP | ID | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2020116 | 01 | |
| ID | 002963800 | 05 |
| Other Name | Type Code |
|---|---|
| FRED MEYER PHARMACY | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942746672 | Fred Meyer Stores Inc | Durable Medical Equipment & Medical Supplies | 5502 Point Fosdick Dr Nw, Gig Harbor, WA 98335-1725 | 2017-01-19 |
| 1154695849 | Fred Meyer Stores Inc | Durable Medical Equipment & Medical Supplies | 26520 Maple Valley Black Diamond Rd Se, Maple Valley, WA 98038-8394 | 2012-02-28 |
| 1053580548 | Fred Meyer Stores Inc | Pharmacy | 2801 Bickford Ave, Snohomish, WA 98290-1734 | 2008-02-28 |
| 1497976930 | Fred Meyer Stores Inc | Pharmacy | 500 Mercer St, Seattle, WA 98109-4654 | 2007-05-01 |
| 1740401272 | Fred Meyer Stores Inc | Pharmacy | 17411 Se 272nd St, Covington, WA 98042-5311 | 2007-05-01 |
| 1689730046 | Fred Meyer Stores Inc | Pharmacy | 1600 W Dravus St, Seattle, WA 98119-1721 | 2006-12-29 |
| 1295809598 | Fred Meyer Stores Inc | Pharmacy | 23475 Ne Novelty Hill Rd, Redmond, WA 98053-5501 | 2006-11-20 |
| 1730253261 | Fred Meyer Stores Inc | Pharmacy | 27008 92nd Ave Nw, Stanwood, WA 98292-5343 | 2006-11-17 |
| 1194899625 | Fred Meyer Stores Inc | Durable Medical Equipment & Medical Supplies | 9999 Holman Rd Nw, Seattle, WA 98117-2041 | 2006-11-17 |
| 1912071440 | Fred Meyer Stores Inc | Durable Medical Equipment & Medical Supplies | 700 Sleater Kinney Rd Ne, Lacey, WA 98503 | 2006-11-17 |
| Street Address |
800 YELLOWSTONE AVE |
| City | POCATELLO |
| State | ID |
| Zip Code | 83201-4433 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508850322 | George N Sedlmayer | Pharmacist | 800 Yellowstone Ave, Pocatello, ID 83201-4415 | 2005-09-08 |
| 1699300392 | James Miles | Pharmacist | 800 Yellowstone Ave, Pocatello, ID 83201-4433 | 2020-03-03 |
| 1063970929 | Jeffrey R Plante | Pharmacist | 800 Yellowstone Ave, Pocatello, ID 83201-4433 | 2019-03-08 |
| 1033483292 | Spencer Adams | Pharmacist | 800 Yellowstone Ave, Pocatello, ID 83201-4433 | 2012-03-05 |
| 1982974747 | Karla Quia-park | Pharmacist | 800 Yellowstone Ave, Pocatello, ID 83201-4433 | 2012-01-10 |
| 1487953816 | Jerry T Holland Jr. | Pharmacist | 800 Yellowstone Ave, Pocatello, ID 83201-4433 | 2011-03-24 |
| 1396044079 | Jared G Turner | Pharmacist | 800 Yellowstone Ave, Pocatello, ID 83201-4433 | 2011-03-21 |
| 1548569569 | Thomas Allen Manske | Pharmacist | 800 Yellowstone Ave, Pocatello, ID 83201-4433 | 2011-03-16 |
| 1144495615 | Kristy Lynn Fordyce | Pharmacist | 800 Yellowstone Ave, Pocatello, ID 83201-4433 | 2008-04-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235765330 | Timothy Palmer | Social Worker | 400 S 11th Ave, Ste 204, Pocatello, ID 83201 | 2020-03-20 |
| 1225687759 | Hanna Percy | Nurse Practitioner | 1151 Hospital Way Ste 201, Pocatello, ID 83201 | 2019-09-07 |
| 1659935195 | Carol Jane Dillon | Counselor | 707 North 7th Avenue, Suite D, Pocatello, ID 83201 | 2019-04-30 |
| 1154801595 | Mv Pocatello Ent, LLC | Otolaryngology | 333 N 18th Ave Ste B3, Pocatello, ID 83201 | 2018-08-15 |
| 1306344346 | Ruth Anne Patton | Social Worker | 850 E Young St, Pocatello, ID 83201 | 2018-01-24 |
| 1598289274 | Lucas Alexander Bryan | Specialist/Technologist | 1535 E Terry St, Pocatello, ID 83201 | 2017-08-03 |
| 1205365632 | Geno Alan Giovanini | Denturist | 115 S. 15th Ave. Ste. D, Pocatello, ID 83201 | 2017-06-08 |
| 1518415942 | Kelli Fries-geslin | Nurse Practitioner | 500 South 11 Ave Suite 400, Pocatello, ID 83201 | 2016-09-14 |
| 1346797842 | Shailyn Jenkins | Specialist/Technologist | 665 Warren Ave., Pocatello, ID 83201 | 2016-09-01 |
| 1992258149 | Christopher Jared White | Social Worker | 300 N 7th Ave, Pocatello, ID 83201 | 2016-07-24 |
| Find all providers in zip 83201 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| 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. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184050148 | Ridley's Family Markets, Inc | Pharmacy | 1000 Pocatello Creek Rd, Pocatello, ID 83201-2926 | 2013-09-23 |
| 1891942413 | Costco Wholesale Corporation | Pharmacy | 305 W Quinn Rd, Pocatello, ID 83201 | 2008-08-26 |
| 1114053444 | Ridley's Family Markets, Inc | Pharmacy | 911 N Main St, Pocatello, ID 83204-2831 | 2007-02-23 |
| 1356367486 | Ed Snell's Pharmacy Shop | Pharmacy | 1015 E Young St, Pocatello, ID 83201-5282 | 2006-07-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295336709 | Family Health Services Pharmacy | Pharmacy | 218 W. Nez Perce, Jerome, ID 83338 | 2020-11-03 |
| 1841806494 | Deblaquiere Enterprises, Inc. | Pharmacy | 86 Tank Rd, Oldtown, ID 83822-5126 | 2020-09-18 |
| 1043838584 | Costco Wholesale Corporation | Pharmacy | 3403 W Chinden Blvd, Meridian, ID 83646-7151 | 2020-07-10 |
| 1265054324 | Costco Wholesale Corporation | Pharmacy | 2495 E Lincoln Rd, Idaho Falls, ID 83401-2203 | 2020-05-12 |
| 1851923544 | Rocky Mountain Pharmacy, LLC | Pharmacy | 3910 Washington Pkwy Ste A, Idaho Falls, ID 83404-7884 | 2020-02-10 |
| 1013559269 | Timberline Pharmacy | Pharmacy | 4574 N Ten Mile Rd Ste 110, Meridian, ID 83646-6930 | 2019-10-09 |
| 1508420373 | K2red LLC | Pharmacy | 447 N Idaho St, Wendell, ID 83355 | 2019-04-27 |
| 1679039135 | Hollis Family Pharmacy LLC | Pharmacy | 845 S Substation Rd, Emmett, ID 83617 | 2019-02-20 |
| 1598229809 | Clearwater Canyon Pharmacy, LLC | Pharmacy | 13020 Us-12, Orofino, ID 83544 | 2019-01-31 |
| 1861999377 | Bi-mart Corporation | Pharmacy | 11347 W State Street, Star, ID 83669 | 2018-04-11 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.