Fred Meyer Stores Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

RP0001321CS Issued in OR

Legal business name

FRED MEYER STORES INC

Practice address

1301 Center Dr
Medford, OR 97501-7938

Phone

(541) 857-4683

Fax

(541) 857-4677

NPI assigned

Jun 18, 2006

Organization subpart

No

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

Authorized official

Name

Allison Muennich

Title

Manager of Pharmacy Licensing

Phone

(513) 762-1019

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• FRED MEYER PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in OR2 enrollments

Enrollment records 2

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

CLIA laboratory certificates

Medicare medical equipment & supply locations

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• The Kroger Co

  • Community/Retail Pharmacy
  • Woodstock, GA
  • NPI 1720012560

  Member Of

  NPD member

Locations

Practitioners 5

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

• Jake Brown

  • Pharmacist
  • Medford, OR
  • NPI 1124800537
  NPD (past)
• Charlene Hoit, PHARMD

  • Pharmacist
  • Medford, OR
  • NPI 1548682065
  NPD (past)
• Yao Luu

  • Pharmacist
  • Medford, OR
  • NPI 1679015929
  NPD (past)
• Tina Nguyen

  • Pharmacist
  • Medford, OR
  • NPI 1497313100
  NPD (past)
• Michael Orion Tice, PHARMD.

  • Pharmacist
  • Medford, OR
  • NPI 1609278274
  NPD (past)

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

{
    "created_epoch": "1150588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758240000000",
    "number": "1174568562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 842772",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02284",
            "telephone_number": "513-762-1019",
            "fax_number": "513-762-1092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 CENTER DR",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975017938",
            "telephone_number": "541-857-4683",
            "fax_number": "541-857-4677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRED MEYER STORES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-18",
        "last_updated": "2025-09-19",
        "status": "A",
        "authorized_official_last_name": "MUENNICH",
        "authorized_official_first_name": "ALLISON",
        "authorized_official_title_or_position": "MANAGER OF PHARMACY LICENSING",
        "authorized_official_telephone_number": "513-762-1019"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OR",
            "license": "RP0001321CS",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2078360",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "123674",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FRED MEYER PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rebecca Michelle Frank
• Dena K Franklin, LMT
• Elizabeth Grace Franklin, BA MLA
• Cora Frantz, FNP-C, DNP
• Fred Meyer Stores Inc
• Freedom Mobility, Inc.
• Angela Marie Freeman, LAC
• Breyanna Nicole Freeman, CNM
• Jonathan C Freeman, M.D.
• Susan Freeman

• Community/Retail Pharmacy in Medford, OR
• Providers in Medford, OR by specialty
• Community/Retail Pharmacy in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2025; 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.