Provider Demographics
NPI:1174633861
Name:BARTELL DRUG CO
Entity Type:Organization
Organization Name:BARTELL DRUG CO
Other - Org Name:BARTELL DRUGS #06906
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
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 1:4025 DELRIDGE WAY SW
Mailing Address - Street 2:STE 400
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98106-1249
Mailing Address - Country:US
Mailing Address - Phone:206-767-1316
Mailing Address - Fax:206-767-1397
Practice Address - Street 1:8862 161ST AVE NE
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052
Practice Address - Country:US
Practice Address - Phone:425-883-9532
Practice Address - Fax:425-882-2743
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
WACF000561963336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA6021448Medicaid
2110504OtherPK
WA033520051Medicaid
WAP00070933OtherMEDICARE B RAILROAD
4926575OtherOTHER ID NUMBER-COMMERCIAL NUMBER
WA4926575OtherNCPCP
WA0333520051Medicare NSC