The Bartell Drug Co

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

CF00002430 Issued in WA

Legal business name

THE BARTELL DRUG CO

Practice address

17633 Highway 99
Lynnwood, WA 98037-3627

Phone

(425) 743-7555

Fax

(425) 745-0808

NPI assigned

Aug 30, 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 #53 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": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481500800000",
    "number": "1609986389",
    "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": "17633 HIGHWAY 99",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980373627",
            "telephone_number": "425-743-7555",
            "fax_number": "425-745-0808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE BARTELL DRUG CO",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "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": "CF00002430",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6027205",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0333520019",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2108251",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BARTELL DRUGS #53",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Andrea I Terrazas
• Yordanos Tsehaye Tesfai, RN
• Kassahun M Tessema
• Diwakar Thapa, PHARM D.
• The Bartell Drug Co
• The Center for Neurodiversity, LLC
• The Gallery of Cosmetic Surgery
• Theodore M Hennessey DDS PS
• Therapeutic Associates Inc
• Therapeutic Bodyworks

• Community/Retail Pharmacy in Lynnwood, WA
• Providers in Lynnwood, 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.