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General NPI Number Information
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NPI Number | 1013305036
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Entity Type | Organization
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Legal Business Name | THE BARTELL DRUG COMPANY
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Dates
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Enumeration Date | 12/29/2014
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Last Update Date | 06/15/2016
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Provider Practice Location Address
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Address Line | 5529 24TH AVE NW
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City | SEATTLE
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State | WA
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Zip | 98107-4102
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Country | US
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Telephone | 206-763-2626
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Fax |
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Provider Business Mailing Address
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Address Line | 4025 DELRIDGE WAY SW STE 400
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City | SEATTLE
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State | WA
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Zip | 98106-1273
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Country | US
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Telephone | 206-763-2626
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Fax |
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Authorized Official
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Title or Position | SR VP OF PHARMACY
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Name | PETER KOO
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Credential | PHARMACIST
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Telephone | 206-763-2626
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | CF.60524626
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License Number State | WA
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