Provider Demographics
NPI:1013990795
Name:BARTELL DRUGS
Entity Type:Organization
Organization Name:BARTELL DRUGS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACY MANAGER/ PHARMASIST
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:ROPERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-303-2584
Mailing Address - Street 1:2119 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98201-2610
Mailing Address - Country:US
Mailing Address - Phone:425-303-4260
Mailing Address - Fax:
Practice Address - Street 1:1825 BROADWAY
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-2348
Practice Address - Country:US
Practice Address - Phone:425-303-2584
Practice Address - Fax:425-258-6252
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-27
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAVA00045095363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty