Provider Demographics
NPI:1073625943
Name:THE BARTELL DRUG CO
Entity Type:Organization
Organization Name:THE BARTELL DRUG CO
Other - Org Name:BARTELL DRUGS #06909
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:ZOREK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-975-5937
Mailing Address - Street 1:200 NEWBERRY CMNS
Mailing Address - Street 2:
Mailing Address - City:ETTERS
Mailing Address - State:PA
Mailing Address - Zip Code:17319-9363
Mailing Address - Country:US
Mailing Address - Phone:717-975-5937
Mailing Address - Fax:717-975-8659
Practice Address - Street 1:100 N 85TH ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-3602
Practice Address - Country:US
Practice Address - Phone:206-784-7601
Practice Address - Fax:206-783-8938
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
WACF604058133336C0003X, 3336C0003X
WACF.00000054333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0333520017Medicaid
WA6033500Medicaid
2107024OtherPK
WA6033500OtherMEDICAID DME
WA6033500Medicaid
WA4906345OtherNCPDP
4906345OtherOTHER ID NUMBER-COMMERCIAL NUMBER