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NPI Code Detail

MEDICARE: THE BARTELL DRUG CO

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
1333600000XPharmacy
23336C0003XCommunity/Retail PharmacyCF00055864WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
32110408OTHERPK

General Provider Information

NPI Number : 1548370232
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE BARTELL DRUG CO
Provider Business Mailing Address
First Line : 4025 DELRIDGE WAY SW
Second Line : STE 400
City : SEATTLE
State : WA
Zip : 98106-1249
Country : US
Telephone Number : 206-767-1316
Fax Number : 206-767-1397
Provider Business Practice Location Address
First Line : 1407 BROADWAY
Second Line :
City : SEATTLE
State : WA
Zip : 98122-3854
Country : US
Telephone Number : 206-726-3495
Fax Number : 206-726-3498
Authorized Official
Title or Position : SR VP OF PHARMACY
Name : PETER KOO
Credential :
Telephone Number : 206-763-2626
Provider Enumeration Date : 08/30/2006
Last Update Date : 12/12/2016

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Directions to “THE BARTELL DRUG CO ” Practice Location

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