MEDICARE: THE BARTELL DRUG CO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy	PHARCF60403731	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2142360	OTHER		PK

General Provider Information

NPI Number	:	1487081634
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE BARTELL DRUG CO

Provider Business Mailing Address
First Line	:	248 BENDIGO BLVD S
Second Line	:
City	:	NORTH BEND
State	:	WA
Zip	:	98045-8134
Country	:	US
Telephone Number	:	206-763-2626
Fax Number	:

Provider Business Practice Location Address
First Line	:	248 BENDIGO BLVD S
Second Line	:
City	:	NORTH BEND
State	:	WA
Zip	:	98045-8134
Country	:	US
Telephone Number	:	425-888-1308
Fax Number	:	425-214-1230

Authorized Official
Title or Position	:	SR VP OF PHARMACY
Name	:	PETER KOO
Credential	:
Telephone Number	:	206-763-2626

Provider Enumeration Date	:	10/02/2013
Last Update Date	:	09/19/2025

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Directions to “THE BARTELL DRUG CO ” Practice Location

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