Provider Demographics
NPI:1508348020
Name:THE BARTELL DRUG CO
Entity Type:Organization
Organization Name:THE BARTELL DRUG CO
Other - Org Name:BARTELL DRUGS #76
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP OF PHARMACY
Authorized Official - Prefix:
Authorized Official - First Name:WING LIM
Authorized Official - Middle Name:
Authorized Official - Last Name:CHOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-767-1394
Mailing Address - Street 1:4025 DELRIDGE WAY SW
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98106-1249
Mailing Address - Country:US
Mailing Address - Phone:206-763-2626
Mailing Address - Fax:206-767-1397
Practice Address - Street 1:9010 MARKET PL
Practice Address - Street 2:
Practice Address - City:LAKE STEVENS
Practice Address - State:WA
Practice Address - Zip Code:98258-4908
Practice Address - Country:US
Practice Address - Phone:425-334-4028
Practice Address - Fax:425-335-1702
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE BARTELL DRUG CO
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-08-31
Last Update Date:2018-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACF.60861918333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy