The Bartell Drug Co

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

CF00004076 Issued in WA

Legal business name

THE BARTELL DRUG CO

Doing business as

Bartell Drugs #39

Practice address

5500 Olympic Dr
Gig Harbor, WA 98335-1487

Phone

(253) 858-7455

Fax

(253) 858-7460

NPI assigned

Aug 25, 2006

Organization subpart

No

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

Addresses

Other identifiers 3

Other names 1

• BARTELL DRUGS #39 Doing business as

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481500800000",
    "number": "1548378102",
    "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": "5500 OLYMPIC DR",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983351487",
            "telephone_number": "253-858-7455",
            "fax_number": "253-858-7460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE BARTELL DRUG CO",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-25",
        "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": "CF00004076",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2108947",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0333520037",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6030282",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BARTELL DRUGS #39",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Gig Harbor, WA
• Providers in Gig Harbor, WA by specialty
• Community/Retail Pharmacy in Washington

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.