Provider Demographics
NPI:1275506990
Name:BARTELL DRUGS COMPANY
Entity Type:Organization
Organization Name:BARTELL DRUGS COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACY TECH
Authorized Official - Prefix:
Authorized Official - First Name:ROYA
Authorized Official - Middle Name:
Authorized Official - Last Name:BEUOKAGHAEI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-265-9365
Mailing Address - Street 1:3701 225TH PL SW
Mailing Address - Street 2:
Mailing Address - City:MOUNTLAKE TERRACE
Mailing Address - State:WA
Mailing Address - Zip Code:98043-4215
Mailing Address - Country:US
Mailing Address - Phone:206-265-9365
Mailing Address - Fax:
Practice Address - Street 1:4727 DENVER AVE S
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98134-2316
Practice Address - Country:US
Practice Address - Phone:206-763-2662
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-13
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183700000XPharmacy Service ProvidersPharmacy TechnicianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAVA00060549OtherPHARMACY TECH LICENSE