Healthcare Provider Details

I. General information

NPI: 1255448544
Provider Name (Legal Business Name): THE BARTELL DRUG COMPANY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2006
Last Update Date: 11/14/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

424 BELLEVUE WAY NE
BELLEVUE WA
98004-5015
US

IV. Provider business mailing address

4727 DENVER AVE S
SEATTLE WA
98134-2316
US

V. Phone/Fax

Practice location:
  • Phone: 425-454-3194
  • Fax: 425-455-5163
Mailing address:
  • Phone: 206-767-1375
  • Fax: 206-767-1397

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberCF00000057
License Number StateWA

VIII. Authorized Official

Name: MR. R. LEON RUSSELL
Title or Position: PHARMACY OPERATIONS COORDINATOR
Credential:
Phone: 206-767-1375