Active NPI
Fred Meyer Stores Inc
Doing business as Fred Meyer Pharmacy
- Community/Retail Pharmacy
- Redmond, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- CF00057350
- Legal business name
- FRED MEYER STORES INC
- Doing business as
- Fred Meyer Pharmacy
- Practice address
- 17667 NE 76TH St
Redmond, WA 98052-4994 - Phone
- (425) 556-8033
- Fax
- (425) 556-8027
- NPI assigned
- Jun 22, 2006
- Last updated
- Sep 19, 2025
- 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
- Allison Muennich
- Title
- Manager of Pharmacy Licensing
- Phone
- (513) 762-1019
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | NU | ||
| Pharmacy | 333600000X | NU | ||
| Community/Retail Pharmacy | 3336C0003X | CF00057350 | WA | Primary |
Addresses
Primary practice location
17667 NE 76TH St
Redmond, WA 98052-4994
Mailing address
P.O. Box 842772
Boston, MA 02284
Phone (513) 762-1019
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6026066 | Medicaid | WA | |
| 2107495 | Other | PK |
Other names 1
- FRED MEYER PHARMACY
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040220000567 | WA | Part B Supplier - Mass Immunization (Roster Biller Only) | 1254234586 | 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 |
|---|---|---|---|
| 50D1005778 | Fred Meyer Pharmacy #00664 | Certificate of waiver | Apr 4, 2028 |
National Provider Directory
National Provider DirectoryMember of 1
Organizations this organization is a member of, according to the National Provider Directory.
-
dba Kroger Pharmacy
- Community/Retail Pharmacy
- Pickerington, OH
- NPI 1245255967
Member Of
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Pharmacist
- Redmond, WA
- NPI 1376818849
-
- Pharmacist
- Redmond, WA
- NPI 1891069613
-
- Pharmacist
- Redmond, WA
- NPI 1568737898
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150934400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1758240000000",
"number": "1841236387",
"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": "17667 NE 76TH ST",
"city": "REDMOND",
"state": "WA",
"postal_code": "980524994",
"telephone_number": "425-556-8033",
"fax_number": "425-556-8027"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FRED MEYER STORES INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-06-22",
"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": "NU",
"license": null,
"primary": false
},
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "WA",
"license": "CF00057350",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6026066",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PK",
"identifier": "2107495",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "FRED MEYER PHARMACY",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Redmond, WA
Sources for this page
- 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.