NPIMap

Organization Active NPI

Fred Meyer Pharmacy

  • Community Health Clinic/Center
  • Twin Falls, ID
National Provider Identifier
1245781574
Registry record updated Oct 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Clinic/CenterTaxonomy code 261QC1500X
License
P5593 Issued in ID
Legal business name
FRED MEYER PHARMACY
Practice address
705 Blue Lakes Blvd N
Twin Falls, ID 83301-4007
Phone
(120) 873-6537
NPI assigned
Oct 21, 2016
Last updated
Oct 21, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2016

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

Authorized official

Name
Dr. Joanne Louise Kreuzer, PHARM. D.
Title
Registered Pharmacist
Phone
(208) 736-5373

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X P5593 ID Primary

Addresses

Primary practice location

705 Blue Lakes Blvd N
Twin Falls, ID 83301-4007

Mailing address

705 Blue Lakes Blvd N
Twin Falls, ID 83301-4007
Phone (120) 873-6537

National Provider Directory

National Provider Directory
Tax ID family
Fred Meyer Store Inc174 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 10

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

Locations

705 Blue Lakes Blvd N
Twin Falls, ID 83301
Phone (208) 239-4033

NPI Registry JSON

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

{
    "created_epoch": "1477008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477008000000",
    "number": "1245781574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 BLUE LAKES BLVD N",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833014007",
            "telephone_number": "120-873-6537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 BLUE LAKES BLVD N",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833014007",
            "telephone_number": "120-873-6537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRED MEYER PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-21",
        "last_updated": "2016-10-21",
        "status": "A",
        "authorized_official_last_name": "KREUZER",
        "authorized_official_first_name": "JOANNE",
        "authorized_official_middle_name": "LOUISE",
        "authorized_official_title_or_position": "REGISTERED PHARMACIST",
        "authorized_official_telephone_number": "12087365373",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARM. D."
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "ID",
            "license": "P5593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Twin Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.