Organization Active NPI

The Bartell Drug Co

  • Pharmacy
  • Seattle, WA
National Provider Identifier
1073060976
Registry record updated Dec 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
PHAR.CF.6065894 Issued in WA
Legal business name
THE BARTELL DRUG CO
Practice address
5625 22ND Ave NW
Seattle, WA 98107-3119
Phone
(206) 783-3051
Fax
(206) 784-9272
NPI assigned
Sep 8, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Peter Koo
Title
Sr VP of Pharmacy
Phone
(206) 763-2626

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X PHAR.CF.6065894 WA Primary
Community/Retail Pharmacy 3336C0003X

Addresses

Primary practice location

5625 22ND Ave NW
Seattle, WA 98107-3119

Mailing address

4025 Delridge Way SW
Suite #400
Seattle, WA 98106-1249
Phone (206) 763-2626

Other identifiers 1

IdentifierTypeStateIssuer
2163696OtherPK

Other names 1

  • Bartell Drugs #71 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161118002236 WA Part B Supplier - Mass Immunization (Roster Biller Only) 2062305501 5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Arlington, WA; Lake Stevens, WA; Seattle, WA; Snoqualmie, WA

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
50D2120904Bartell Drugs #715625 22ND Ave NW, Seattle, WA 98107Certificate of waiverApr 4, 2028

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1473292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481846400000",
    "number": "1073060976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4025 DELRIDGE WAY SW",
            "address_2": "SUITE #400",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981061249",
            "telephone_number": "206-763-2626",
            "fax_number": "206-767-1397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5625 22ND AVE NW",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981073119",
            "telephone_number": "206-783-3051",
            "fax_number": "206-784-9272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE BARTELL DRUG CO",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-08",
        "last_updated": "2016-12-16",
        "status": "A",
        "authorized_official_last_name": "KOO",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "SR VP OF PHARMACY",
        "authorized_official_telephone_number": "206-763-2626"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "WA",
            "license": "PHAR.CF.6065894",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2163696",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bartell Drugs #71",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.