Provider Demographics
NPI:1639281611
Name:BARTELL DRUG CO
Entity Type:Organization
Organization Name:BARTELL DRUG CO
Other - Org Name:BARTELL DRUGS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:THIRD PARTY COORDINATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:TONI
Authorized Official - Middle Name:R
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-767-1371
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:98106-1273
Mailing Address - Country:US
Mailing Address - Phone:206-767-1371
Mailing Address - Fax:206-767-1397
Practice Address - Street 1:16940 116TH AVE SE
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98058-5952
Practice Address - Country:US
Practice Address - Phone:425-226-2901
Practice Address - Fax:425-235-9080
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE BARTELL DRUG COMPANY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-31
Last Update Date:2012-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
4906054OtherOTHER ID NUMBER-COMMERCIAL NUMBER
WA6032700OtherMEDICAID DME
WA6032700Medicaid
WAP00070933OtherMEDICARE B RAILROAD
WA4906054OtherNCPCP
WA6032700Medicaid
4906054OtherOTHER ID NUMBER-COMMERCIAL NUMBER