Healthcare Provider Details

I. General information

NPI: 1639281611
Provider Name (Legal Business Name): BARTELL DRUG CO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 10/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16940 116TH AVE SE
RENTON WA
98058-5952
US

IV. Provider business mailing address

4025 DELRIDGE WAY SW STE 400
SEATTLE WA
98106-1273
US

V. Phone/Fax

Practice location:
  • Phone: 425-226-2901
  • Fax: 425-235-9080
Mailing address:
  • Phone: 206-767-1371
  • Fax: 206-767-1397

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MS. TONI R HALL
Title or Position: THIRD PARTY COORDINATOR
Credential:
Phone: 206-767-1371