Active NPI
The Bartell Drug Co
Doing business as Bartell Drugs
- Community/Retail Pharmacy
- Everett, WA
National Provider Identifier
1487766358
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- CF00002428
- Legal business name
- THE BARTELL DRUG CO
- Doing business as
- Bartell Drugs
- Practice address
- 11020 19TH Ave SE
Everett, WA 98208-5155 - Phone
- (425) 337-7197
- Fax
- (425) 337-9287
- NPI assigned
- Aug 31, 2006
- Organization subpart
- No
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | CF00002428 | WA | Primary |
Addresses
Primary practice location
11020 19TH Ave SE
Everett, WA 98208-5155
Mailing address
4025 Delridge Way SW
Ste 400
Seattle, WA 98106-1249
Phone (206) 767-1316
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2108249 | Other | PK | |
| 0333520002 | Medicaid | WA | |
| 6025605 | Medicaid | WA |
Other names 1
- BARTELL DRUGS
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040226000423 | WA | Part B Supplier - Pharmacy | 2062305501 | This NPI is an additional NPI on the enrollment |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 50D2055510 | Bartell Drug #06925 | Certificate of waiver | Apr 4, 2028 |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1481500800000",
"number": "1487766358",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4025 DELRIDGE WAY SW",
"address_2": "STE 400",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981061249",
"telephone_number": "206-767-1316",
"fax_number": "206-767-1397"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11020 19TH AVE SE",
"city": "EVERETT",
"state": "WA",
"postal_code": "982085155",
"telephone_number": "425-337-7197",
"fax_number": "425-337-9287"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "THE BARTELL DRUG CO",
"organizational_subpart": "NO",
"enumeration_date": "2006-08-31",
"last_updated": "2016-12-12",
"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": null,
"license": null,
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "WA",
"license": "CF00002428",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PK",
"identifier": "2108249",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0333520002",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6025605",
"state": "WA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "BARTELL DRUGS",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Everett, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 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.