Provider Demographics
NPI:1518517101
Name:THE BARTELL DRUG CO
Entity Type:Organization
Organization Name:THE BARTELL DRUG CO
Other - Org Name:BARTELL DRUGS #77
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP OF PHARMACY
Authorized Official - Prefix:
Authorized Official - First Name:BILLY
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 STE 400
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98106-1273
Mailing Address - Country:US
Mailing Address - Phone:206-763-2626
Mailing Address - Fax:
Practice Address - Street 1:2506 2ND AVE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98121-1427
Practice Address - Country:US
Practice Address - Phone:206-363-0565
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE BARTELL DRUG CO
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-09-16
Last Update Date:2019-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAPHAR.CF.60960888OtherWA STATE DEPT OF HEALTH