FRED MEYER STORES INC NPI 1700801347

NPI Information

  • NPI: 1700801347
  • Provider Name: FRED MEYER STORES INC
  • Classification: Pharmacy - 3336C0003X
  • Specialization: Community/Retail Pharmacy
  • Entity Type: Organization
  • Doing Business As: QFC PHARMACY #205
  • CLIA Number: 38D0979856
  • Address: 5544 E BURNSIDE ST
    PORTLAND, OR
    ZIP 97215
  • Phone: (503) 239-7710

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NPI Details

FRED MEYER STORES INC is a community/retail pharmacy pharmacy in Portland, OR. The provider is a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. FRED MEYER STORES INC NPI is 1700801347. The provider is registered as an organization entity type.
The provider Is Doing Business As Qfc Pharmacy #205.

The provider's business location address is:

5544 E BURNSIDE ST
PORTLAND, OR
ZIP 97215-259
Phone: (503) 239-7710
Fax: (503) 239-4073

The provider's authorized official is Allison Muennich .
The authorized official title is Manager Of Pharmacy Licensing and has the following contact phone number (513) 762-1019.

The CLIA number assigned to this NPI record is 38D0979856 - pharmacy with a certificate type of Certificate of Waiver.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count (HCPCS:K1034)
  • Administration of influenza virus vaccine (HCPCS:G0008)
  • Influenza vaccine split virus, preservative free (HCPCS:90662)
  • Adm sarscv2 30mcg trs-sucr b (HCPCS:0054A)
  • Fee covid-19 vac 13 res (HCPCS:0124A)

The enumeration date for this NPI number is 7/13/2006 and was last updated on 9/19/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1333600000XPharmacyNo
2332B00000XDurable Medical Equipment & Medical SuppliesNo
33336C0003XPharmacyCommunity/Retail Pharmacy1787OREGONYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1P01392984MEDICARE PIN
22079039OTHERPK
3182133MEDICAIDOREGON
40509530175MEDICARE NSC
5R149649MEDICARE PIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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